Saakashvili's hunger strike almost hit a month - what do we know about his health and what future awaits him?

November 1 will mark exactly one month since the third president of Georgia, Mikheil Saakashvili was detained and went on a hunger strike in the Rustavi prison. It is known that during this month Saakashvili only took 50 milligrams of honey during the first week of the hunger strike.

Doctors monitoring him say that at any moment the ex-president’s health could deteriorate sharply.

The authorities refused to transfer the ex-president to any medical facility other than the prison hospital. However, according to the Public Defender of Georgia, there is neither the equipment necessary for his treatment, nor safe conditions for the former president in there, who has many enemies among the representatives of the criminal world.

Mikhail Saakashvili refuses to end his hunger strike and does not agree to go to the prison hospital. He stated that while he is in custody, he will not accept food in any form. Saakashvili disagrees with his conviction and considers himself a political prisoner.

Saakashvili’s lawyers are allowed in, family members, several friends, as well as the Ukrainian ombudsman (the former president of Georgia is currently a citizen of Ukraine) have already visited him.

JAMnews has collected everything that is known so far about the former president’s hunger strike and the state of his health.

One month of hunger strike

Public Defender of Georgia Nino Lomjaria was the first to visit Mikhail Saakashvili after his transfer to prison. Lomjaria met with Saakashvili on the day of his arrest, October 1, and said after the meeting that the ex-president did not agree with the verdict, considered himself a political prisoner and went on a hunger strike.

On October 4, one of Saakashvili’s lawyers, Nika Gvaramia, published a letter in which the former president announced that he would not end the hunger strike until his release.

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Mikheil Saakashvili bought seven cans of honey and natural juice from a prison store and began ate some of them, head of the penitentiary service Nika Tskhvariashvili said on October 8. On the same day, Saakashvili’s personal doctor Nikoloz Kipshidze said that Saakashvili had not eaten and had lost 12 kilograms due to the hunger strike.

• Entry into Georgia and its detention – which preceded the start of the famine

  

  On September 27, Mikheil Saakashvili posted on his Facebook page a ticket for the Kiev-Tbilisi plane, showing that he would arrive in Georgia with his mother Giuli Alasania on October 2, on the day of the municipal elections. On October 1, he informed the public via Facebook that he was already in Georgia. On the same day, he released two videos in which he announced that he was in Batumi.

  Initially, the Interior Ministry claimed that “Mikhail Saakashvili did not cross the Georgian state border and did not leave Ukraine”. Saakashvili’s visit was also denied by the ruling Georgian Dream party. Mamuka Mdinaradze said that the ex-president was vacationing at the resort of Truskavets in Ukraine.

  At the end of the day, at 19:45 in the evening, Georgian Prime Minister Irakli Garibashvili, together with the Minister of Internal Affairs and the head of the state security service, held a special briefing and said that “the wanted Saakashvili has been arrested”. According to him, the relevant departments had information about Saakashvili’s route in advance and chose to detain him with fewer obstacles.

Two days later, on October 10, the doctor spoke about the need to transfer Saakashvili to the hospital. According to him, the former president was only drinking water and his health had deteriorated.

On the same day, Nikoloz Kipshidze, in an interview with reporters, said that Saakashvili has a rare blood disease – thalassemia:

“A hunger strike is absolutely unacceptable with such a blood disease. This leads to irreversible changes”, Kipshidze said, explaining that the third president himself gave him the right to make this information public.

However, the presence of this disease in Saakashvili has not yet been publicly confirmed by any other specialist.

Later, the penitentiary service denied the information disseminated by Saakashvili’s doctor about the deterioration of his health, stating that Saakashvili was constantly under the supervision of medical staff and his condition was satisfactory.

On October 11, Eka Kherkheulidze, a member of the United National Movement party who visited Rustavi prison and the former president, explained that Saakashvili had bought five 50 milligram jars of honey from the prison store on the recommendation of a doctor. Upon learning of speculation on this topic, he returned four jars to the administration.

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On the same day, Saakashvili’s doctor Nikoloz Kipshidze said that the former president was experiencing difficulties with movement, his speech had changed, and the doctor was afraid that Saakashvili would not be able to survive until October 30, when the second round of elections is scheduled.

On the twelfth day of the hunger strike, October 12, Saakashvili’s lawyer Bek Basilai also said that because of the hunger strike, the former president had difficulty walking and talking.

On the same day, October 12, the Ministry of Justice applied to the Ministry of Health with a request to create a multifunctional group of doctors to monitor the condition of Mikhail Saakashvili.

• What is Saakashvili accused of

  

  Saakashvili is accused of abuse of power, embezzlement of budget funds, dispersal of the opposition rally in November 2007 and the defeat of the Imedi TV channel. Saakashvili also appears in the cases of the beating of deputy Valery Gelashvili and the murder of bank employee Sandro Girgvliani by the Interior Ministry officers.

  Saakashvili has already been convicted on two counts – for organizing the beating of Gelashvili and for pardoning those convicted for the murder of Girgvliani. Saakashvili was sentenced to six years in prison. The Georgian authorities have repeatedly stated that the wanted ex-president will be arrested as soon as he returns home.

  On October 20, the prosecutor’s office brought a new charge against already detained Saakashvili –  illegal crossing of the state border.

According to the Georgian Ombudsman, statements by the penitentiary service or high-ranking politicians about the former president create an additional threat of the starving Saakashvili refusing medical assistance.

The physical condition of the third president is getting worse and worse, Bek Basilai’s lawyer said on October 15. On the same day, Saakashvili’s personal doctor Nikoloz Kipshidze was admitted to prison by a decision taken at a meeting of doctors in the Ministry of Health.

On October 19, a council of doctors convened under the leadership of the Ministry of Justice and the Ministry of Health recommended that the ex-president be hospitalized.

Cardiologist Zurab Pagava said that the 20th day of the hunger strike is critical and the likelihood of complications is increasing. Refusing to eat for that long can lead to sudden cardiac arrest, poor blood circulation in the brain, instability of sugar levels and other complications, he said.

After visiting the prison on October 20, one of Saakashvili’s lawyers, Dimitri Sadzaglishvili, said that Saakashvili had agreed to medical intervention, but continued his hunger strike. The lawyer also presented to the public another letter of Saakashvili, in which he stated: “While I am under arrest, I will not receive food in any form, and I am ready to die”.

According to the Ministry of Justice, if Saakashvili’s condition deteriorates, he will be transferred to a prison hospital.

The Public Defender assessed whether the medical institution No. 18 complies with the recommendations of the council on the treatment of Mikhail Saakashvili. In the conclusion of the Ombudsman it is said that if a patient has complications, he must be transferred to an institution where there is the appropriate equipment – computed tomography (CT), doppler scanning, as well as magnetic resonance imaging (MRI). On October 24, the Ombudsman said the prison hospital did not comply with the council’s recommendations and if Saakashvili is transferred there, there will be a threat to his safety. “The Ministry of Justice should choose an alternative medical institution for Saakashvili”, the Ombudsman said.

On the 25th day of the hunger strike, Saakashvili’s lawyer Dimitri Sadzaglishvili said that one of the ex-president’s vital indicators had dropped to a critical level the night before and he needed the intervention of resuscitators. “At any moment, a sharp deterioration of his health is expected, so urgent medical care is high on the agenda”, Sadzaglishvili said.

On the 26th day of the hunger strike, 19 non-governmental organizations issued a joint statement on the need to hospitalize the ex-president. The letter says that the issue of hospitalization of Saakashvili should be decided by the government not out of political expediency, but only to ensure a high level of protection of the human right to life, health and personal safety.

On October 26, Saakashvili posted on his Facebook page a statement that no matter how severe his health condition is, he refuses to be transferred to a prison hospital.

On October 27, Saakashvili’s lawyer Sadzaglishvili said that the prison administration had set up a barrier between the prisoner and the visitor in the meeting room with Mikheil Saakashvili, effectively limiting their direct communication with him.

Later, a Ukrainian doctor, Rada deputy Maxim Perbiynis, told reporters that he could not examine Saakashvili. According to him, the third president of Georgia refuses medical services and tests.

“I think that any person who is fasting for 27 days is a patient who needs medical supervision, some medical tests. Misha said that from now on, since he is denied legal assistance, he refuses medical supervision, he refuses to undergo tests and medical procedures to monitoring his health during the hunger strike”, the doctor said.

On the same day, Mikheil Saakashvili was visited by the human rights ombudsman of Ukraine Lyudmila Denisova. After the meeting, she stated that Saakashvili’s rights were being violated.

Examples of hunger strikes in Georgia

A hunger strike is a voluntary and conscious refusal to eat in protest. This is a last resort and is often used when other means of protest have been exhausted or unavailable. For example, in prisons there are often hunger strikes with different requirements.

There are different forms of hunger strikes. However, prolonged refusal to eat is, in any case, harmful to the body and affects almost all organs. In addition, the body becomes very vulnerable, especially to infections. It is believed that six weeks after the hunger strike starts, a healthy person may be on the verge of death.

After a month of refusing to eat or losing 18% of body weight, severe and irreversible medical complications begin. It is difficult for starving people at this time even to drink water, they can lose their hearing and eyesight, have difficulty breathing, and their organs begin to malfunction. After 45 days, there is a very high chance of death due to heart failure or a serious infection.

A few months ago, the leader of the Russian opposition, Alexei Navalny, went on a hunger strike because his personal doctor was not allowed to visit him in prison. Navalny was on a hunger strike for 24 days.

The hunger strike is used in Georgia as a form of protest, both in and outside of prisons.

One of the latest cases was the hunger strike of the residents of the Shukruti village of the Chiatura municipality. They protested against the work carried out by the Georgian Manganese company, as a result of which their houses were in disrepair.

There are also cases of hunger strikes in the prisons of Georgia. Prisoners usually demand that their conditions in prison be improved or their cases reviewed.

The prison administration resolves this problem through negotiations or intimidation of prisoners, and, as a rule, the cases of hunger strikes of prisoners often remain unknown to the general public, unless family members or lawyers of the prisoner share them with the media.

There is a precedent of the death of a starving inmate in a Georgian prison. It occurred in 2018, under the current government.

In December 2018, 34-year-old Giorgi Paseishvili died in Gldani prison after a 40 days of a hunger strike.

The cause of death was complications caused by starvation. As explained in the penitentiary service, Paseishvili refused not only food, but also medical treatment.

“The diagnosis was acute liver failure, unspecified thrombocytopenia, unspecified coagulopathy, delirium, hypoglycemia. The accused moved in a wheelchair, was underweight and weak”, the penitentiary service said in a statement.

Paseishvili was arrested for attempted murder, he pleaded not guilty and demanded a review of the case.

When a prisoner goes on a hunger strike, the Public Defender must be informed about it. However, in the case of Paseishvili, as noted by the Ombudsman, no such message was received.

During the Soviet era, force-feeding, or the threat of force-feeding, was practiced. Sometimes this measure is still used in developed countries, if the life of a prisoner is in danger.

Forced feeding takes place with the help of the so-called probe – a tube is inserted into the nose of a starving person through which food enters the stomach.

Although the goal in such cases is to save human life, force-feeding is considered inhuman and cruel treatment.

It does not only make eating painful but can also lead to health complications, such as internal bleeding.

In Georgia, throughout the years of its independence, not a single fact of the use of forced feeding in prisons has been recorded.