117. Regarding girls and female adolescents, the IACHR also takes into consideration the fact that they are the principal victims of sexual abuse by their schoolmates and teaching or administrative staff in schools and that sexual violence, harassment, groping, verbal humiliations or rapes are generally accompanies by threats of physical punishment, the use of force, manipulation, or the promise of financial or academic rewards. The IACHR also points out that only few teachers have formal training for teaching topics relating to sexuality, sexual abuse, and the rights of the child.142 On this, the Committee on the Rights of the Child has stated that it "notes with concern continuing authoritarianism, discrimination, disrespect and violence which characterize the reality of many schools and classrooms. Such environments are not conducive to the expression of children’s views and the due weight to be given these views" and it concludes that "Giving children’s views weight is particularly important in the elimination of discrimination, prevention of bullying and disciplinary measures."143 118. In addition, the IACHR has stressed that one of the risk factors for sexual violence in the educational sector has to do with the very nature of educational institutions, in which relations of trust are formed between pupils and teaching or administrative staff, in which the latter can misuse their authority to commit acts of sexual violence. Another factor has to do with cover-ups and institutional tolerance of perpetrators. Finally, a third factor may be associated with the weakness of justice system mechanisms for responding to violations, together with individual factors that raise the potential for sexual violence (gender, age, ethnicity, sexual diversity, disability, migration, poverty, and living in rural or marginalized areas.144 119. For the IACHR, given that school is the primary setting for teaching, development, and socialization and plays a vital part in the life and formation of children and adolescents, the existence of harmful practices violating their rights by the personnel responsible for safeguarding them in the design, implementation, and supervision of education, impairs the right to receive adequate, high-quality education in a safe environment and in the best interests of the child. For the IACHR, protecting girls and adolescents against sexual and gender-based violence in school not only constitutes an immediate, priority requirement; it also demands the involvement and commitment of the entire educational apparatus, from the crafting of teaching materials imbued with a human rights and gender equality approach; the construction of appropriate toilet facilities; access to impartial and timely information regarding sexual and reproductive rights; the training and sensitization of bother teaching and administrative staff; comprehensive reparation for the victims; proper administrative and criminal investigation and punishment of those responsible for sexual violence. 120. As regards the right to health, both the IACHR and the Inter-American Court of Human Rights have pronounced on the links between the right to humane treatment and the right to health.145 The InterAmerican Court has repeatedly voiced its interpretation that the right to humane treatment is directly and closely linked with human health care.146 and that "lack of adequate medical care" may constitute a violation of that right. 147 The Commission considers that this intrinsic link constitutes a manifestation of the interdependence and indivisibility of civil and political rights, on the one hand, and economic, social, and cultural rights, on the other. As the Court puts it, both sets of rights should be "fully understood as human rights, without any rank and enforceable in all cases before competent authorities."148 ACHR, Access to Justice for Women Victims of Sexual Violence. Education and health, December 28, 2011, par. 101. Committee on the Rights of the Child, General Comment No. 12. United Nations document CRC/C/GC/12, July 20, 2009, paras. 105 and 109. 144 IACHR, Access to Justice for Women Victims of Sexual Violence. Education and health, December 28, 2011, par. 145 IACHR, Report No. 102/13, Case 12.723, Merits, TGGL, Ecuador, November 5, 2013. IACHR. Report: Access to Maternal Health Services from a Human Rights Perspective. June 7, 2010. Section II: 146 I/A Court HR. Case of Suárez Peralta v. Ecuador. Preliminary Objections, Merits, Reparations, and Costs. Judgment of May 21, 2013. Series C No. 261, par. 130; and Case of Vera Vera et al. v. Ecuador. Preliminary Objection, Merits, Reparations and Costs. Judgment of May 19, 2011. Series C No. 226, par. 43. 147 I/A Court HR. Case of Suárez Peralta v. Ecuador. Preliminary Objections, Merits, Reparations, and Costs. Judgment of May 21, 2013. Series C No. 261, par. 130; Case of Tibi v. Ecuador. Preliminary Objections, Merits, Reparations, and Costs. Judgment of September 7, 2004. Series C No. 114, par. 157; and Case of Vera Vera et al. v. Ecuador. Preliminary Objection, Merits, Reparations and Costs. Judgment of May 19, 2011. Series C No. 226, par. 44. 148 I/A Court HR. Case of Acevedo Buendía et al. (“Discharged and Retired Employees of the Office of the Comptroller) v. Peru Preliminary Objection, Merits, Reparations and Costs. Judgment of July 1, 2009. Series C No. 198, par. 101. Along those same lines, see: United Nations Committee on Economic, Social and Cultural Rights. General Comment No. 9, para. 10. 142 143