A number of media reports, arguing that South Ossetians are offered free quality medical care in exchange for taking Georgian citizenship, caused a public outcry and strong reaction from Leonid Tibilov, the head of unrecognized republic. In particular, the president of South Ossetia declared unfounded the referrals to medical institutions of Georgia as this often does not comply with the Government’s Decree on transporting citizens to the hospitals outside the country in order to provide emergency medical care.

“The document clearly states that, with the assistance of the International Committee of the Red Cross (ICRC), the patient can be sent to other states in cases of emergency: when the patient’s condition does not allow to transport him/her to health clinics of the Russian Federation,” he stressed during the meeting with the heads of relevant ministries and agencies.

According to the media reports, Red Cross workers transport people to Georgia even for out-patient visits to specialists and consultants who allegedly are not available in Tskhinvali. While transportation to the clinic is free, the treatment is at the patients’ expense – in the case of hospitalization, it can range up to 500 dollars a day. If a person is unable to pay for the services, he is offered free medical care in exchange for taking Georgian citizenship.

For example, in June a young woman was taken to Tbilisi to give birth to a child. After that, she was presented with a bill for more than a thousand dollars and as an alternative offered to restore her Georgian citizenship. In the end, she agreed to change citizenship in order not to pay money.

Commenting on the media reports, public relations officer of the ICRC mission in South Ossetia Marina Tedeti stressed that the Red Cross is not the initiator of medical transportations.

“Procedurally, it looks like this: close relatives of the patient receive permission from the Ministry of Health and Ministry of Foreign Affairs of South Ossetia, and only then come to our office. We do not have medical staff to determine severity of the disease and urgency of the transportation needed. People come to us with a specific request and all the necessary permits from the official authorities. Only then we provide transportation. We do not take any other responsibility, for example, for evaluation of the severity of the disease, or cost and quality of the services received in Georgia,” she said in an interview with news agency “PenzaNews.”

Moreover, according to her, the ICRC does not have any information about the cases when South Ossetians were offered free medical care in exchange for taking Georgian citizenship.

“We have no such information, and we are not trying to obtain it. People, who use our program of medical transportation to Georgia, know that the financial burden for the services provided by medical facilities is their problem, and we inform them about it in advance,” Marina Tedeti explained.

Ilgar Velizade, political analyst, deputy chief of the filial branch of RIA “Novosti” in Azerbaijan Republic, chief of the International Press-Centre “Novosti” in Baku, said he was uncertain about the project carried out by the ICRC in Tskhinvali.

“The program that provides medical treatment to residents of South Ossetia in Georgian cities indicates cultural contacts in the conflict zone and it should be welcomed. However, if the organization of the treatment and the specific actions of the Red Cross specialists are as described in the media reports, it is absolutely unacceptable and incompatible with basic ethical standards. “Citizenship” obtained under such circumstances is illegitimate and is not for the benefit of Georgia itself,” the analyst said.

According to him, Tbilisi strategy towards South Ossetia and Abkhazia “Engagement through Cooperation” is above all pursuing humanitarian goals, and is unlikely to be effective if the authorities try to achieve specific political objectives with it.

“There is nothing wrong with that South Ossetians could seek professional medical help in various medical institutions of Georgia and thus receive quality services. In Georgia, as in any other country, there are differences in the provision of paid services for citizens and non-citizens: citizens enjoy discounts and insurances that are not provided for non-citizens. However, if the patient is offered to change his citizenship in the course of treatment – when refusal is fraught with serious complications – such a method is not valid and looks like the pressure,” Ilgar Velizade said, stressing that health cannot be subject of political speculation.

Kamal Sido, the head of Middle East Department of the Society for Threatened Peoples (STP), also considers proposals to change citizenship unlawful.

“People, who are in difficult life circumstances and face financial difficulties, can be easily persuaded to take this step. But this is wrong, because a change of citizenship is a serious long-term solution, which is not to be taken in such conditions,” the expert said, adding that these actions may be interpreted as indirect pressure.

In his opinion, this strategy can be beneficial to those who want to change the demographic situation in the region. According to the expert, humanitarian assistance is sometimes used in an attempt to change public opinion and influence the course of events.

“Similar situation was, for example, in Iraq, where Kurds and Turkmen were offered to change their nationality to Arabs in exchange for various benefits. The Armenian authorities in the Soviet era often indirectly forced Kurds who professed Yezidism to record their nationality in the passport as “Yezidi,” despite the fact that it is a religion. And today Turkey tries to influence Kurdish areas of Syria through humanitarian assistance,” Kamal Sido explained.

“If the ICRC cooperates with the authorities of Georgia and it leads to the fact that the residents of Abkhazia and South Ossetia are changing their citizenship in favor of another country – this is wrong. It is necessary to find out what really happened, and then take the action,” he added.

George Hewitt, professor of Caucasian languages at the School of Oriental and African Studies, a fellow of the British Academy and the honorary consul for Abkhazia to the UK, criticized Georgian policy towards South Ossetia.

“The first point that needs to be made is that Georgia’s State Strategy on The [sic] Occupied Territories, a failed policy introduced by the government of the outgoing failed president, should have been abrogated as soon as Bidzina Ivanishvili’s party came to power. Like all the other policies of Mikhail Saakashvili with regard to South Ossetia and Abkhazia, it has contributed nothing positive to relations between these republics and Georgia,” he said.

If there is actual evidence that employees of the Red Cross have been or are infringing their organization’s strict policy of absolute neutrality, then appropriate representations should be made to the RC’s head-quarters in Switzerland, the expert believes.

“It is totally unacceptable to put pressure on patients by placing this option before them precisely at a moment of medical crisis,” George Hewitt emphasized.

In his opinion, since the Georgian authorities regard South Ossetia and Abkhazia as integral parts of Georgia, it follows that their citizens should logically be treated in hospitals or clinics in exactly the same way as residents of regular Georgian regions are treated.

“If a special case is being made for residents of South Ossetia and Abkhazia effectively in order to bribe them into accepting Georgian citizenship, then one could argue that this cynical ploy should be treated with equal cynicism by the person traveling for treatment: viz. take the citizenship, enjoy free treatment, and then renounce the citizenship once back home so as not to be liable to the accusation of holding the citizenship of a hostile state,” he said.

The best way out, according to him, can be the formal recognition of state sovereignty of South Ossetia and Abkhazia.

“Two decades have now passed since South Ossetia and Abkhazia went their separate ways. Tbilisi will in the final analysis have to realize that it simply has no alternative but to accept reality, follow Russia’s decision of 26 August 2008 by offering recognition, and then proceed to establishing good-neighborly relations with the states concerned. Everyone will then know where they stand, including where best to go to benefit from essential and affordable medical treatment,” George Hewitt concluded.

The International Committee of the Red Cross (ICRC) is an independent and neutral organization that works worldwide to provide humanitarian help for people affected by conflict and armed violence and to promote the laws that protect victims of war.

The ICRC is not an intergovernmental organization in the legal sense. However, it is recognized in the most important international treaties, which defines its international status and mandate and provides working facilities (privileges and immunities) comparable to those of the United Nations. Examples of these facilities include exemption from taxes and customs duties, inviolability of premises and documents, and immunity from judicial process
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