facility, the Polyclinic of the Guayas Traffic Commission, and those provided in the private institution, the Minchala Clinic. The Court finds that this resulted in a situation of risk, which the State was aware of, that materialized in adverse effects on the health of Melba Suárez Peralta.” 52 In addition, the Inter-American Court affirmed that “the State’s supervision and inspection should be designed to ensure the principles of availability, accessibility, acceptability, and quality of the medical services” and, to this end, it emphasized that “regarding the quality of the service, [...] health facilities must have satisfactory conditions of hygiene and trained medical personnel.” 53 29. In this analysis, the Inter-American Court referred expressly to different international instruments, resolutions and sources that regulate or have direct implications for the protection of the right to health: (i) Article 26 of the American Convention on Human Rights; 54 (ii) Article 10 of the Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights, ratified by Ecuador on March 25, 1993, which establishes that everyone shall have the right to health, understood to mean the enjoyment of the highest level of physical, mental and social well-being, and indicates that health is a public good. 55 (iii) Article XI of the American Declaration on the Rights and Duties of Man, which indicates that every person has the right “to the preservation of his health through sanitary and social measures relating to […] medical care, to the extent permitted by public and community resources”; 56 (iv) Article 45 of the Charter of the Organization of American States, when stating that the Member States are required “[t]o dedicate every effort to the [… d]evelopment of an efficient social security policy”; 57 (v) Article 12 del International Covenant on Economic, Social and Cultural Rights. 58 (vi) The Social Charter of the Americas of June 2012, adopted by the General Assembly of the Organization of American States, which emphasizes the quality of the health establishments, goods and services, which require the presence of qualified medical personnel, as well as satisfactory conditions of hygiene; 59 52 Para. 154 of the Judgment. 53 Para. 152 of the Judgment. 54 Footnote 176 [Nota: not 176] of the Judgment. This note refers to the mention made to the OAS Charter in para. 131, from which the Inter-American Court derives the right to health; although I consider that it should have considered article 34(i) of the OAS Charter. 55 Cf. para. 131 of the Judgment. The Case of Vera Vera et al., supra, para. 43, is cited. 56 Cf. para. 131 of the Judgment. 57 Cf. para. 131 of the Judgment. 58 Cf. para. 152 of the Judgment. 59 Cf. para. 131, in fine, of the Judgment. 11