Looking thin and unwell, former Georgian President Mikheil Saakashvili appeared at a Tbilisi court hearing this morning via video link from a hospital bed, his head propped up by a pillow. After several months of appeal following his worsening health, the court hearing was to determine whether Saakashvili would have his sentence suspended due to poor health.
He is currently serving a six-year prison sentence on charges of abuse of power, which his supporters claim are politically motivated.
Earlier this month, the Penitentiary Service, an agency under the Justice Ministry, denied Saakashvili the opportunity to attend his court hearing via video link from the hospital due to a "lack of suitable technical equipment."
International support for the 54-year-old former president has grown over the last few weeks in tandem with the visible decline of Saakashvili's condition in the military hospital facility where he is now receiving treatment.
"Mercy is necessary, especially before Christmas. What is happening to Mikheil now is cruelty. This does not befit Georgia. This has to stop," Ukrainian President Volodymyr Zelenskiy said in a December 19 video address, joining the latest international appeal for Saakashvili to receive medical care abroad.
"Please make a decision that can save his life. Transfer Mikheil Saakashvili to one of the clinics in Ukraine, another European country, [or] in America," Zelenskiy said.
Following his arrest in October 2021 after illegally crossing into Georgia, Saakashvili, who was president from 2004 to 2013, has staged repeated hunger strikes in protest against his imprisonment. His health appears to have deteriorated significantly.
During the trial, Saakashvili, who has been a Ukrainian citizen since 2015, came into conflict with the judge, who insisted that he stop speaking Ukrainian and address the court in Georgian. The judge also said that should Saakashvili lift up his shirt to show his injuries, as suggested by his lawyer, Shalva Khachapuridze, he would disconnect him from the live broadcast.
Moldovan President Maia Sandu, EU ambassador to Georgia Pawel Herczynski, and U.S. Ambassador to Georgia Kelly Degnan are some of the international voices who have expressed concern over Saakashvili's health, urging the government to ensure his rights are protected.
The Georgian Dream government has accused Saakashvili of exaggerating his illness, releasing on December 14 edited video footage of him in his hospital room as alleged proof of Saakashvili's dramatization of his ailments.
The video shows Saakashvili looking frail, walking with a mobility aid, and being checked by medical staff. After a hunger strike in the fall of 2021, Saakashvili was moved to a military hospital in Gori, a central city 90 kilometers from the capital, Tbilisi, to receive treatment. In May, he was moved to a civilian ward in the same hospital.
"In the mentioned video material, Mikheil Saakashvili's simulated actions are clearly visible, the purpose of which is to hinder the implementation of justice, to mislead society and international partners," a statement released by the Penitentiary Service says.
The statement says that the footage "reflects the state's attitude toward Mikheil Saakashvili" and showed that he treated staff with "abuse and aggressive behavior."
Saakashvili's lawyer, Khachapuridze, has claimed that the Penitentiary Service's distribution of the footage without Saakashvili's consent amounts to a criminal offense.
"This video material…was made public without the prisoner's permission," Khachapuridze said. "Then let's add to this the fact that different periods are edited, and if there is a dispute about this, and believe me, the time will come, we will remove it."
He added that the editing of footage from different time periods presents the patient "from the point of view that the government arranged."
The office of the Public Defender, an independent ombudsman that oversees human rights and freedoms in Georgia, released a statement in which it expressed alarm over Saakashvili's declining health, citing a report published on December 6 by a group of experts monitoring his treatment.
"According to the assessment of the group, compared to the previous period, [his] encephalopathy, sensorimotor neuropathy, anemia have worsened, and newly discovered autonomic neuropathy has been added with a significant drop in blood pressure upon standing up," the statement reads.
"Anorexia has transformed into life-threatening cachexia, which had been repeatedly predicted by the group of experts, and at the time of the evaluation, the patient was in a phase of active catabolism (self-digestion), which was proved by a very rapid weight loss."
Saakashvili's legal team made public a toxicology report in early December, based on the findings of several U.S. doctors, which claimed that the former president had likely been "poisoned" by heavy metals. A U.S.-based toxicologist quoted in the report said that samples taken from Saakashvili's body showed signs of mercury and arsenic.
The government's release of the hospital video, which it cited as being of "high public interest," was intended to show the former president's "aggressive behavior" toward hospital staff. At moments in the edited footage, Saakashvili appears agitated and upset with staff.
However, the Penitentiary Service's efforts to demonize Saakashvili may have backfired, with growing public outcry over the government's intransigence on allowing him to leave the country to seek medical attention abroad. Georgian social media has been dominated by calls for his transfer abroad.
The disagreement over Saakashvili's detention and health is a high-stakes iteration of the political polarization that characterizes Georgian political life, with the government and the opposition locked in enmity and an absence of constructive debate.
In Georgia, while there are a number of opposition parties, the two forces that dominate are the opposition United National Movement founded by Saakashvili and tycoon and former Prime Minister Bidzina Ivanishvili's Georgian Dream. It is personality, rather than ideas, that defines Georgia's political culture, and it is not uncommon for support to be solicited by insulting political opponents.
The rise of Georgian Dream and its ability to win the 2012 elections was based on a mandate defined by being an alternative to Saakashvili, who was facing public backlash after his second term in office. While Saakashvili's first presidential term, which began in 2004 after the bloodless Rose Revolution, saw sweeping and largely successful reforms, his second term was marked by emerging authoritarian tendencies and a stifling of media freedom.
Georgian Dream Chairman Irakli Kobakhidze slammed Saakashvili's video court appearance as an "unprofessional simulation," claiming to journalists that a gastric bypass accounts for Saakashvili's weight loss. "This is the only thing we can see from the video," he said.