Defense lawyers for an alleged Islamic extremist told International Criminal Court judges Tuesday that he is suffering from post-traumatic stress disorder and could be unfit to stand trial on charges that he policed a brutal Islamic regime in Timbuktu after al-Qaida linked rebels overran the historic Malian desert city in 2012.

As the trial Al Hassan Ag Abdoul Aziz Ag Mohamed Ag Mahmoud got underway, defense attorney Nicoletta Montefusco said that judges should appoint an expert to assesses his fitness to stand trial.

Montefusco said defense lawyers couldn't meet their client face-to-face for four months because of COVID-19 restrictions and when they finally met him they were “alarmed” by his condition.

An expert who subsequently had a phone consultation with Al Hassan wrote a letter last week saying that he was “experiencing dissociative features that result from severe maltreatment,” Montefusco said. Defense lawyers have previously told the court that Al Hassan was tortured while in custody in Mali before he was sent to The Hague.

Lawyers argue that the dissociative disorder impairs Al Hassan's memory of events.

Judges adjourned the case for 45 minutes to consider the issue.

Al Hassan, who sat in court wearing a face mask and white headscarf, is charged with involvement in crimes including rape, torture, enforced marriages and sexual slavery from April 2012 until the end of January 2013.

He didn't immediately enter a plea as the trial started before going into a closed session so judges could read out all the allegations without putting victims at risk by having their identities read in open court.

Al Hassan allegedly was a key member of Ansar Dine, an Islamic extremist group with links to al-Qaida that held power in northern Mali at the time. Prosecutors say Ansar Dine imposed a brutal regime on Timbuktu residents including public floggings, amputations and forced marriages.

“Al Hassan is alleged to have exercised powers and functions on a daily basis within the Islamic police,” said Presiding Judge Antoine Kesia-Mbe Mindua.

A French-led military operation in 2013 forced Al Hassan and others from power, though elements have continued to stage numerous attacks on Malian and international forces.

The trial opened against a backdrop of political tensions in Mali following contested legislative elections. On Sunday, protesters ransacked a building belonging to President Ibrahim Boubacar Keita’s political party.

The trial is the second case at the ICC linked to Ansar Dine's brutal occupation of Timbuktu. A member of the group, Ahmad Al Faqi Al Mahdi, was convicted in 2016 and sentenced to nine years’ imprisonment for attacking nine mausoleums and a mosque door in the city in 2012. At previous hearings, Al Mahdi pleaded guilty and expressed remorse for his role in leading the destruction.