Georgia's ailing ex-president Mikheil Saakashvili on Thursday, Dec. 22, looked frail as he appeared by video link at a court that will consider deferring his sentence of abuse of office over poor health.

Gaunt, hollow-cheeked and his hands trembling, Saakashvili was connected from hospital by video link. The footage was aired live from court by the independent Pirveli TV station.

The 55-year-old was transferred from prison to hospital last year after refusing food for 50 days to protest his jailing, which rights groups say is politically motivated.

Doctors who examined Saakashvili in person have said he is facing life-threatening complications stemming from his detention conditions.

"We demand Mikheil Saakashvili is allowed to go abroad for medical treatment as per doctors' recommendation," his lawyer Dito Sadzaglishvili told AFP.

Toxicologist David Smith meanwhile said tests had revealed that Saakashvili had been exposed to poisoning by heavy metals while in custody and that he needs "immediate transfer to a medical facility outside Georgia."

The European Union and United States have urged the Georgian government to ensure Saakashvili is provided a proper medical treatment and his rights are protected.

Georgian authorities insist Saakashvili is being given adequate medical care.

The founder of Georgia's main opposition force and president between 2004 and 2013, Saakashvili was convicted in absentia for abuse of office and sentenced to six years in prison in 2018.

The pro-Western reformer was imprisoned in October 2021, days after secretly returning from exile in Ukraine.

In October, the Council of Europe rights watchdog called for the "release of political prisoners opposed to (Russian President Vladimir) Putin in the Russian Federation and other countries, including Mikheil Saakashvili".

Amnesty International has branded his treatment as "apparent political revenge".

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