CEDAW/C/77/D/143/2019 experienced emotional pain and suffering as a result of the discriminatory conduct of the private health-care provider. 2.6 On 13 September 2016, the authors filed a lawsuit again st the private health facility. They asked the court to establish a violation of their right to equal treatment and to award non-pecuniary damages. 2.7 On 5 April 2017, during a court hearing, witnesses from both sides were heard. The defendant’s witnesses did not refer to the exact events of December 2015 but spoke in general about the professional work of the gynaecologist. In her statement at the end of the hearing, the defendant explained that she had changed her policy towards Roma patients because, once, the Health Education and Research Association had brought to her practice a Roma couple (a husband and a wife with an infection). They wore filthy clothes and had an unpleasant smell, and after they left, she had to disinfect and ventilate the room as the patient “had a pungent smell, smelled like a sewer” and the gynaecologist feared that other patients might avoid her practice. 2.8 On 7 June 2017, the court rejected the authors’ claims as unfounded. The court found that the authors did not act to meet their own needs; rather, the events were to be seen as part of а simulated project of the Health Education and Research Association, which was confirmed also by the report of the Association itself and the statements of the witnesses. 2 The court further stated that the authors were not discriminated against based on their ethnicity but rather, they were rejected because they failed to submit their complete medical file (they were not carrying their health identification cards and medical records). The authors appealed against the decision. 2.9 On 17 May 2018, the appellate court delivered its decision without holding a public hearing. It rejected the appeal and upheld the first-instance decision. According to the authors, the appellate court did not provid e a reasonable justification for the decision. According to the authors, domestic remedies were thus exhausted. Complaint 3.1 The authors claim that the State’s failure to provide them with effective protection against discrimination in access to health-care services amounts to a violation of their rights under articles 1, 2 (a), (c) and (e) and 12 of the Convention, taking into consideration the Committee’s general recommendation No. 24 (1999) on women and health. 3 They contend that the lack of gynaecological services in the area in which they live is a form of discrimination against women and that the State party’s failure to introduce positive measures in favour of the sexual and reproductive health rights of Roma women resulted in inequality in practice in the authors’ enjoyment of their right to health. 3.2 The authors contend, in particular, that they have suffered discrimination as they were refused enrolment as patients by the local gynaecologist and denied a regular gynaecological examination owing to their ethnicity, while non-Roma women were admitted and examined on the same day. They also claim that the court had lacked an understanding of the nature, specificity and intersectionality of the discrimination, as __________________ 2 3 20-16465 The control subjects stated that they had been engaged by the Association to play а role in exchange for compensation. The authors refer extensively to the concerns expressed by the Committee in its 2006, 2013 and 2018 concluding observations on the combined initial, second and third periodic reports, the combined fourth and fifth periodic reports and the sixth periodic report of the State party. See, respectively, CEDAW/C/MKD/CO/3, paras. 27–28; CEDAW/C/MKD/CO/4-5, paras. 16, 33 and 37–38; and CEDAW/C/MKD/CO/6, paras. 11 (c), 19, 20 (c) and 37–38. They also refer to the concluding observations of the Committee on Economic, Social and Cultural Rights on the combined second to fourth periodic reports of the State party (E/C.12/MKD/CO/2-4), paras. 49–50, and its general comment No. 14 (2000) on the right to the highest attainable standard of health, paras. 12 and 21. 3/10