A/HRC/57/47 and gender-based violence against Indigenous women and girls with disabilities who are living in institutions.75 65. A lack of access to reproductive health care, especially in remote areas, and complications in pregnancy, amplified by high rates of domestic and sexual violence, lead to lasting impairments and disability status for Indigenous women. Domestic violence perpetrated against pregnant women often leads to fractures in the fetus, head trauma or other fetal injuries that, if not treated properly, can lead to impairments in the newborn. 76 The importance of addressing the intersectionality of domestic and sexual violence, access to reproductive health care and impairments in Indigenous communities cannot be overstated. On their own, each of these challenges affect Indigenous women in particular. Compounded by one another, they have lasting effects on Indigenous Peoples that can only be addressed through an intersectional approach. 66. The marginalization experienced by Indigenous women with disabilities is gravely compounded because they experience the intersection of gender discrimination, racial discrimination and discrimination against persons with disabilities. Consequently, this leads to a higher likelihood of poor mental health, exacerbating preexisting economic and social conditions and creating a vicious cycle of disenfranchisement. The experience of being Indigenous and female, coupled with being a person with a disability, can be so intense that a mental health condition may develop into a psychosocial disability. 77 VII. Climate change and environmental impact on Indigenous persons with disabilities 67. With their profound cultural and physical connection to their territories, Indigenous Peoples are markedly more affected by climate change and its adverse impacts, especially when they are displaced from their land.78 There are very little data on the impact of climate change and climate action on persons with disabilities, and in particular Indigenous persons with disabilities. Climate change threatens the full enjoyment by Indigenous persons with disabilities of the universal human rights to life, education, movement, justice, property, work, social protection, leisure and an adequate standard of living. 68. Climate change also exacerbates existing difficulties for Indigenous persons with disabilities, in particular those in rural areas, 79 leading to health issues and violations of human rights,80 including as a result of the loss of ecosystems and exposure to pollution from industrial operations. 81 They are disproportionately affected by natural disasters, experiencing higher rates of injury and death as a result of inaccessible communication and information, inadequate or inaccessible evacuation plans and shelters and lack of accessible transportation.82 69. For example, climate change has caused shorter winters and a lack of sea ice in northern Greenland. The change in climate has affected seal-hunting and caused a reduction in income and food sources for Inuit Peoples.83 70. Changes in temperature and precipitation patterns can also limit the availability of medicinal plants and animals and traditional healing practices, affecting the health and 75 76 77 78 79 80 81 82 83 14 General recommendation No. 39 (2022), para. 9. Submission from the Center for Reproductive Rights. Submission from the National Indigenous Disabled Women Association Nepal. International Disability Alliance, Indigenous Peoples with Disabilities Global Network and Endorois Indigenous Women Empowerment Network, The Impact of Climate Change on Indigenous Peoples with Disabilities in Baringo County, Kenya (2023), p. 9. World Meteorological Organization, 2023 State of Climate Services: Health (Geneva, 2023). Submission from the Ministry of Social and Economic Inclusion, the Ministry of Public Health and the National Council for Disability Equality of Ecuador. Submission from Guatemala. Submission from Australia. Submission from the Tilioq, Greenland. GE.24-12379