A judge with the Pietermaritzburg High Court in South Africa issued an arrest warrant Tuesday for former president Jacob Zuma. The ex-president was scheduled to appear for a pre-trial hearing but did not show up.

Zuma’s lawyer, Daniel Mantsha, presented a doctor’s note from a South African military hospital, certifying that Zuma had received two operations in January and was currently receiving further medical treatment abroad. He has apparently been out of the country since January 23. Mantsha did not describe Zuma’s condition beyond saying it was an issue of “state security.”

Prosecutor Billy Downer asked for the warrant to be issued. Mantsha objected, noting that it was “absurd” that a document from a military hospital was being questioned, but Judge Dhaya Pillay expressed doubts about the note’s authenticity because it lacked sufficient details about the ex-president’s condition. He issued the arrest warrant, but stayed its effect until May 6, which is Zuma’s next scheduled court appearance.

The former president is facing charges of fraud, corruption, racketeering, and money laundering related to a $2.5 billion European arms deal in the 1990s.