On November 4, 2021, Public Defender's representatives again inspected Facility No. 18 for the possible admission of the third President of Georgia, Mikheil Saakashvili. The purpose of the visit was to monitor the degree of compliance of the facility with the medical standards indicated in the new reports of the medical council (dated November 3, 2021 and October 28, 2021). Public Defender's representatives checked what changes were made in the facility after the previous visit paid on October 24, 2021.

The inspection revealed that the facility had been equipped with a Doppler scanner and intensive infrastructural preparations had been launched for the installation of a computed tomography device. According to the administration and medical staff of the facility, the process will be completed in a few days. In addition, the facility employed 5 resuscitation specialists, who are on duty continuously. At the same time, Public Defender's representatives once again made sure that the facility has a fully equipped laboratory and relevant medical staff.

Despite the positive changes, the current situation in the facility, in terms of medical care, unfortunately, still does not fully comply with the reports and recommendations made by the multifunctional group of doctors on November 3, 2021 and October 28, 2021. In particular, the facility does not have a catheterization laboratory and is not equipped with a magnetic resonance imaging device. Consequently, in case Mikheil Saakashvili is transferred to Medical Facility No. 18, he will not be provided with all the necessary medical services specified in the report of the council.

As for the issue of ensuring Mikheil Saakashvili's personal safety and providing him with conditions conducive to dignity, the Public Defender reiterates that placing a prisoner of the category of Establishment No. 12 in a facility where he may have contact with other prisoners creates safety and disorganization risks for both Establishment No. 8 and Establishment No. 18. The situation in this regard has not changed since the previous visit. Physical safety risks have been minimized in the facility, although the existing infrastructure or environment cannot preclude the risk of verbal aggression, noise, verbal abuse or psychological pressure by certain groups of prisoners. It will also be problematic for visitors to visit Mikheil Saakashvili, as any visitor, including lawyers, will have to walk through the yard of Establishment No. 8, close to other inmates' residential buildings, which increases the risks of verbal confrontation and abuse.

The Public Defender considers that Facility No. 18 generally can provide appropriate services to prisoners with a variety of medical needs, including hunger strikers. However, the needs of each prisoner are identified individually by a specialist doctor or a council, which must be strictly met by the penitentiary system. In addition, along with the provision of medical services, it is inadmissible to place any prisoner in an environment that violates his/her honor or dignity.

The Public Defender reiterates that the Ministry of Justice/Special Penitentiary Service should be guided by the reports of the multifunctional group of doctors and the obligation of providing an environment conducive to human dignity and should select an alternative medical facility.