By Alexandra Sansosti, MD
When 17-year-old Jorge Mario Bergoglio told his mother he wanted to enter the Catholic seminary, Regina Maria Sivori, an Argentine woman of Italian descent, had hoped her son would study medicine instead. But he offered a different interpretation of his choice: he would become “a doctor for the soul.” It was a promise kept.
Decades later, as Pope Francis, he would devote his papacy to the marginalized—the poor, the outcast, and the displaced—following the model of his namesake, St. Francis of Assisi. After assuming the role of pontiff in unprecedented fashion in 2013, his first official trip was not to a global capital or distant land, but to the small Italian island of Lampedusa.
As the self-described Pope "from the end of the Earth," Francis made a deliberate and symbolic choice. Perched at the southern edge of Europe and the heart of the Mediterranean, the island is geographically peripheral yet central to the story of forced migration. I came to know this during a year-long research fellowship on Lampedusa, working alongside frontline Italian physicians who cared for arriving migrants and studying the systems designed to support them.
Far removed from the power corridors of Brussels or Rome, Lampedusa is witness to one of the world’s most urgent humanitarian crises. While migration remains a subject of heated debate across Europe, few have seen its daily reality as it unfolds on this rocky shore.
Pope Francis recognized that the migrant’s journey is not only physical, but profoundly spiritual. To leave one’s homeland and cross deserts and seas, he suggested, demands extraordinary courage of the soul. In Lampedusa, he offered solidarity and solace—urging compassion and calling on the faithful to receive migrants not as strangers, but as neighbors. He prayed for the displaced—and for those who risk their lives to protect them.
Regina Maria Sivori would be proud of the men and women who now safeguard the migrants her son so fervently championed. While the Pope has called for greater European coordination at the continent’s borders, it is on the island of Lampedusa that this vision quietly takes shape. There, a small but deeply committed team of Italian healthcare workers receives the exhausted, injured, and often critically ill migrants who survive the harrowing journey across the Mediterranean. One night, a severely dehydrated woman disembarked after days at sea. During the chaos of disembarkation, her young son was thrust into my arms, his whereabouts unknown to her. I promptly returned him to her after she was tended to, but her fear visibly lingered. By morning, she was being treated in the clinic for severe chemical burns—caused by the mixing of spilled gasoline and salt water pooled in the base of the boat during the crossing. Much of the skin on her buttocks and the backs of her legs had been stripped away. She said little during her treatment, clutching her son’s hand while the physicians worked. She was one of the lucky ones—she had made it.
The team works with urgency—triaging, stabilizing, treating, and transferring patients, many of whom arrive in life-threatening condition. In a striking paradox, Lampedusa—long known as a flashpoint of Europe’s migration crisis—has become one of the most medically resourced of Italy’s 77 inhabited islands. The local clinic maintains round-the-clock pediatric and obstetric care, operates an emergency helicopter for critical transfers, and is soon to be equipped with a CT scanner to diagnose life-threatening brain injuries. These resources have saved the lives of both residents and migrants, turning the island into a quiet but crucial outpost of care at the threshold of Europe.
On Lampedusa, the word for migrants is often colloquially replaced with “clandestini,” or “clandestine people.” Throughout history, clandestine Catholics practiced their faith in secret—under Roman persecution, in Elizabethan England, behind the Iron Curtain. They whispered prayers, worshipped in hiding, and risked imprisonment for the right to believe. They were not criminals, but souls in search of sanctuary, navigating a world that viewed their presence as destabilizing. Today, clandestine migrants do the same. They cross deserts and seas, evade detection, and arrive at borders not to conquer but to survive—in pursuit of dignity, safety, and the right to live freely. Like underground believers, their invisibility is not a sign of guilt, but a symptom of a system that has not yet made room for them.
They ask: Do you see me? Will you protect me? Will you make space for me—not just in your laws, but in your heart?
Reflecting on his visit to Lampedusa, Pope Francis entreated his followers to answer this question:
“That is what happens when the heart hardens... and becomes indifferent. Please, we have to get our hearts to feel again. We cannot remain indifferent in the face of such human dramas. The globalization of indifference is a very ugly disease.”
In choosing to become a doctor of the soul, Pope Francis reminded us that healing is never only physical. On Lampedusa, that vision is made real—not just through IVs and emergency flights, but in the simple act of receiving migrants with dignity and making space for them in the healthcare system.
To begin making that space, we must first resist what the late Pope called the hardening of the heart. We must build systems of care that reflect what I witnessed on Lampedusa: medicine practiced not only with compassion, but with the foresight that another patient will arrive tomorrow—and that care paradigms for the marginalized must endure.
Access to physical and mental healthcare is not a gesture of generosity—it is the bare minimum of justice. We cannot call ourselves civilized while allowing suffering to pool at our borders. It is not enough to feel compassion. We must structure it. Deliver it. Insist on it.
Related:
- Frontline Humanity in Lampedusa: How Migration Shapes the Island’s Medical Mission
- Global Surgery and Gender Equity Take the Spotlight at the First Pan-African Surgical Congress
- The Modern International Surgical Mission Starts Local and Stays Local