Georgia’s former president Mikheil Saakashvili has appeared on television for the first time in months, looking frail and emaciated, fuelling concerns over the detained politician’s treatment. The 55-year-old was almost unrecognisable and looked like a ghost of his former self when he appeared in a video link for a court hearing on Monday. The images prompted war-torn Ukraine – of which Saakashvili is a citizen – to summon the Georgian ambassador, asking him to go to Tbilisi to help “save” Saakashvili. The leader of the Caucasian country from 2004 to 2013, Saakashvili was jailed after returning from exile on charges that rights groups denounced as politically motivated. Doctors have said Saakashvili risks dying from conditions he has developed while in custody, though Georgian authorities say he is being given adequate medical care. Appearing via video link for a court hearing on the “abuse of office” charges, Saakashvili, 55, lifted his shirt to show his ribs protruding from his chest, a hollow abdomen, and skin clinging tightly to his bones. “A totally innocent man is being kept in custody,” he said in coverage carried live on several independent TV channels. “I did not commit any crime.” He is being held at a civilian hospital, where he was transferred last year after staging a 50-day hunger strike to protest against his detention. “Putting me in jail will not break me,” he said. “I am going to be actively involved in Georgian politics.” The Ukrainian president, Volodymyr Zelenskiy, said the Georgian ambassador to Kyiv would be asked to “leave Ukraine within 48 hours to hold consultations with his capital” on Saakashvili’s treatment. Zelenskiy wants Saakashvili, who he made a Ukrainian citizen in 2019, to be transferred to a clinic in Ukraine or the west. He called on Georgia to “hand over” Saakashvili to Ukraine and “save this man”. It was not immediately clear if the ambassador was being formally expelled. The Ukrainian foreign minister, Dmytro Kuleba, said the ambassador would arrive at his offices on Tuesday. “Tomorrow morning the Georgian ambassador will be at the foreign ministry. We will have a tough conversation with him, he will go to Georgia,” Kuleba said on social media. Kyiv, which has been battling a Russian invasion for 16 months, has accused Tbilisi of increasingly cooperating with Moscow. Zelenskiy accused Russia of “killing” Saakashvili “at the hands of the Georgian authorities”. Two groups of doctors, one set up by Georgia’s rights ombudsman, another consisting of US-based medics, have said that Saakashvili’s health continued to decline well after he ended his hunger strike. The group of US-based doctors, who examined Saakashvili in person, said his deteriorating health was the result of “torture” in custody, saying he needed an immediate transfer to a medical centre abroad. The politician, who once weighed more than 100kg , has lost about 60kg while in prison, the doctors group said. The EU and the US have urged Georgia to ensure that Saakashvili is provided medical treatment and that his rights are protected. Amnesty International has described his treatment as “apparent political revenge”.