Brazilian President Jair Bolsonaro will miss a summit in Colombia on fires in the Amazon Rainforest for another surgery to fix damage caused by last year’s failed assassination attempt, his spokesperson confirmed on Monday.

“On the grounds of medical advice, the president will need to go on a liquid diet from Friday. The consequence of this is to practically make a trip to Leticia unfeasible at this time,” spokesperson General Otávio Rêgo Barros in a statement to reporters on Monday.

Bolsonaro will soon undergo his fourth surgery since being stabbed by a socialist during last year’s presidential campaign. The procedure is medium in size and will be done at Vila Nova Star Hospital in Sao Paulo. According to a medical bulletin Bolsonaro published on social media, he is undergoing the surgery due to the emergence of a hernia caused by the previous incision.

Rêgo Barros added that officials are now considering alternative options given that Bolsonaro cannot attend.

“The options the Brazilian government are currently considering include the possibility of a substitute for the President of the Republic, so that he can be represented at the event,” he said. “Another option is a postponement, so that the president himself, due to the importance of the matter, will be able to attend the meeting.”

The summit was agreed to last week with the idea of bringing together all Latin American countries with Amazonian territories to discuss the ongoing situation, which has drawn concern and condemnation from around the world.

After the meeting had concluded, participants intended to issue a joint communiqué defending their national sovereignty, principally in response to the concerns raised by French President Emmanuel Macron at the recent G7 Summit about an internationally coordinated effort to reduce the fires.

One of Macron’s proposals included G7 states providing a $20 million donation to help tackle the fires. Bolsonaro rejected the offer until Macron rescinded insults against him. Chief of Staff Onyx Lorenzon accused the French leader of having a “colonialist” mindset and failing to address problems in his own country such as the recent burning of the Notre-Dame cathedral.

The rainforest spans across a total of eight countries including Bolivia, Peru, Ecuador, Colombia, Guyana, Suriname, and French Guiana, although Brazil has the largest amount of territory. Venezuela also has sizeable territory; socialist dictator Nicolás Maduro was not invited to the meeting.

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