From the outside, the Madre di Misericordia clinic may not seem like much. In fact, it’s easy to miss the clinic entirely.Located
just steps from the security lines where tourists and pilgrims wait to
enter St. Peter’s Basilica, the entrance to the clinic is modest enough
that a passerby could easily mistake it for a small office, or not
notice it at all.
But
since its inauguration at the behest of Pope Francis in 2016, the
clinic has progressively expanded its services and today it serves
around 2,000 patients per month – mostly people living in the streets of
Rome – free of charge, with a group of almost 120 medical professionals
working in the clinic as volunteers.
“We have about
60 to 70 patients per day, some days when we have many specialties
available we reach 100 or 110, but the monthly average is around 2,000
patients, although there are months in which we have 3,000 patients,”
Dr. Massimo Ralli, director of the clinic since 2021, told The Pillar.
The clinic was inaugurated in 2016, during the extraordinary Jubilee of Mercy.
“There
was a small room used for pilgrims when there was a medical emergency,
and then the old post office was renovated to inaugurate a proper
clinic, which was finally done in January 2019,” Ralli, who was also
appointed undersecretary of the Dicastery for the Service of Charity on
June 30, added.
San
Martino, a second clinic with two additional rooms adjacent to the
Madre di Misericordia clinic, was inaugurated by Pope Leo in November
2025.
Archbishop Luís Marín de San Martín, OSA,
prefect of the Dicastery for the Service of Charity, which is in charge
of the clinic, told The Pillar that Pope Francis was moved by a desire to help people who had a difficulty in accessing healthcare services.
“These
are primarily homeless people, who are often undocumented and therefore
unable to access health care. Although we know that health care is
legally guaranteed for everyone in Italy, for these individuals it is
often limited to the management of medical emergencies, while primary
care, diagnostic tests, rehabilitation, and the provision of medications
are frequently denied to them,” Marín said.
Marín de San Martín said the clinic’s service is inspired by the Gospel story of the Good Samaritan.
“It
is important to reflect on the figure of the Good Samaritan who, upon
encountering a brother in distress, ‘approached [him], poured oil and
wine over his wounds and bandaged them. Then he lifted him up on his own
animal, took him to an inn and cared for him.’ (Lk 10:33–34). We must
never forget that in the flesh of the poor, we touch the flesh of
Christ.”
“It was this vision of faith—even before any
charitable initiative—that gave rise to the clinic as a concrete
expression of a Church that is a mother and bends down to embrace her
most wounded children,” Marín added.
Ralli said that,
although Italy guarantees hospital care for all, some people still face
obstacles when trying to access certain healthcare services.
“When
a patient comes here, in many cases these are people who have no
documents, no Italian health card, and do not know how to get medical
care. Approximately 40% of our patients are Italians and 60% are
foreigners. Many do not know how to be assisted. We know that anyone on
the national territory can go to the emergency room, and they’re
treated, but we also try to give that person an embrace, we try to take
care of them. We welcome them,” Ralli said.
While
non-emergency services are covered by Italy’s healthcare system for
patients with Italian healthcare assistance, even those enrolled in
assistance programs are often required to pay a co-payment that, though
modest for many, can represent a significant burden for the poor.
“Many
people, even if they are poor, do not have an exemption for the
co-payment in all cases. That may happen for missing documents or other
bureaucratic issues. So, even if a medical visit costs just 20 euros,
for them that can be the difference between eating or going to the
doctor. The same happens with medicines, even if someone is enrolled in
the healthcare system, they have to pay for basic medicines such as
Ibuprofen, so we help them with this as a form of direct charity,” Ralli
added.
Marín added that sometimes the barriers to healthcare access are not legal but social.
“Some
of these people may fear judgmental stares and rejection that further
wounds their dignity. For these people, our clinic represents a place
they can access free of charge, without needing a referral, and where
they can be certain to find qualified people who will welcome them with
open arms and outstretched hands. Anyone in need who comes to us is
welcome—a brother, a sister. That is enough,” the archbishop said.
“Our
doctors welcome them warmly, listen to them, and are there for them.
The poor are at the heart of their service. This is because they see
Christ in their faces, and by healing them, they heal Christ. Many of
those who come to us need to talk, to share their story. Although it
would be desirable for this same welcoming attitude toward the most
vulnerable to be present in all healthcare facilities and institutions, I
believe we must start with ourselves,” he added.
Dr. Ralli told The Pillar
that it is essential for the clinic to operate at the same standard as
other Italian healthcare facilities, offering patients not only medical
care but also a concrete expression of their dignity.
“Patients
arrive and undergo a registration process as in any hospital, they’re
asked what they need and if they’re not registered in the system, we
register them. Then, they get a ticket with their name, what needs to be
done, and their time of arrival.”
“For example, if
someone has an x-Ray, they get their report on a CD and in a folder. It
may not seem like much, but it’s important to restore dignity to people
also through these gestures: the person feels listened to and cared for”
Ralli added.
The doctors in the clinic seem to live
by Ralli’s words. The patients call the doctors by their first names,
and make jokes with them. As Ralli tours the clinic, patients stop him
to ask questions, and he listens attentively, looking them in the eye.
Ralli added that treating mostly poor, homeless people is no excuse for providing sub-standard care.
“We
must do everything in the best possible way for the poor. A simple
example: the doctors’ coats arrive ironed and clean every day. The
doctor takes the coat, uses it and then puts it to be washed. The same
coat is not used every day. These are small details, but they restore
dignity to the person, and this matters a great deal to us,” Ralli told The Pillar while changing the exam table paper in one of the clinic’s offices after an appointment.
While
the clinic has over 120 volunteers and covers nearly every single
medical specialty, the physical space is small, which means that
scheduling the visits of specialists each month is a logistical
operation in itself.
“Some of our doctors are retired
physicians who come here as volunteers, others are doctors in active
service, nurses, technicians and pharmacists that make some of their
time available for us,” he said. “Every day, we have five or six doctors
on duty, and the calendar is made public on the website.”
“A
lot of people come here by word of mouth, but others come redirected
from parishes, so the parish staff can always access the schedule and
tell people when they’re supposed to come. Parishes work as our meeting
point, as our bridge to the poor. While sometimes they go to parishes
looking for food or financial support, in many cases, there’s also a
health problem, so the parish priest himself becomes the bridge.”
Ralli
said that, in fact, they have more doctors and medical professionals
asking to come as volunteers than available slots each month and
sometimes have doctors sharing a room to see their patients.
“Often
we have more doctors asking to come on a given day than we have
available spaces. So we ask them to take turns sharing a room, so as not
to take away from a poor person the opportunity to have that visit. We
keep order, but we try not to lose any possibility of care,” he added.
When Ralli says that nearly every single specialty and fundamental service is covered in the clinic, it’s not an overstatement.
The
clinic conducts blood tests which are processed by the Vatican State’s
Directorate of Health and Hygiene. “They can do all the necessary
analyses, even the more difficult or specific analyses can be done in
three or four days,” Ralli added.
“There are also
many pregnant women who are taken care of in the Santa Marta Dispensary.
They assist many pregnant women who have been in Italy for a short
time, less than three months, in which they cannot get a health card
while they regularize their paperwork, but pregnancy doesn’t wait for
regularization, so the dispensary brings the women here and we can do
all the tests necessary to accompany them.”
Ralli said the clinic also offers dental care and ophthalmological services.
“Dental
care is also very important because people living in the streets only
think of their teeth when they hurt. And you know how much a toothache
hurts, so imagine how it is to be on the street in that kind of pain and
without being able to buy medicine. We have dentists and technicians
who come to make an assessment and make prosthesis if needed.”
“This
is essential because someone without teeth cannot eat properly, cannot
smile or present themselves well. Imagine a 30-year-old person who is
trying to get a job but has no teeth, how can that person feel confident
in presenting himself publicly?” Ralli added.
The clinic also has a special collaboration with a foundation which provides eyeglasses for patients who need them.
“There
are a lot of patients that come asking for eyeglasses. We have seen
people with five or six degrees of myopia who didn’t have glasses. It is
impossible to reintegrate into work and society if you can’t even see
what’s in front of you,” he said.
“We have
ophthalmologists come here every week and conduct eye exams. We also
have a collaboration with the OneSight EssilorLuxottica Foundation,
which donated very advanced instruments to us. Thanks to the
collaboration, an optician comes twice a month with all the frames so
that the patient can choose their frame as you would do in an optical
shop. They can come to collect them a week later,” Ralli added as he
showed one pair of eyeglasses they had recently received for a patient.
“They are beautiful glasses, like the ones you would choose for
yourself.”
On November 16, 2025, during the jubilee
of the poor, the San Martino clinic was inaugurated, where now X-Rays
tests are conducted.
“We were able to do several
diagnostic tests: electrocardiograms, spirometries, audiometric tests,
eye exams, and ultrasounds. We had the issue of X-rays, but since the
new clinic was open now we can do radiology tests, and we now also have
this space so that more doctors can come and see patients when it’s not
being used for X-rays,” Ralli said.
“This space is
often used for oncology, we have an oncologist come every week and do
assessment, blood tests, screenings, everything that is needed. And if
there’s a diagnosis made, we accompany and guide them so that they’re
able to get the care they need in the Italian healthcare system,” he
added.
As Ralli speaks, one theme repeatedly emerges —
a theme that also surfaces often in conversations and interviews with
Archbishop Marín de San Martín: concrete charity.
“The
location of this place is very symbolic, we’re right under the Holy
Father’s window, so it feels like the Church is embracing these people
in its own home. It’s under the colonnata, which is almost like two arms
outstretched to embrace the poor that come to us.”
“It’s
all concrete charity. It’s one thing to give two euros to a person on
the street with back pain. That’s charity, of course, but it’s a
completely different thing to tell them, ‘come, a doctor will see you
and help you,’ it’s about giving you a concrete, direct solution to an
issue you have.”
Archbishop Marín de San Martín agrees.
“True
charity is not a theory, it’s concrete practice. It’s born from God. As
the famous and ancient antiphon says, ubi caritas et amor, Deus ibi
est. God is present every time someone tends their hand to a needy
person or sits down by a suffering person to listen to them. This is not
a merely metaphoric present, but sacramental. The poor, the suffering
person, is locus theologicus, a source of theological reflection and
encounter with God.”
“We cannot bear witness to the
Gospel without living it out in concrete acts of charity; we cannot
truly celebrate the Eucharist unless we encounter Christ in our brother
or sister who is suffering,” he added.
For both Marín de San Marín and Ralli, the work of the clinic is profoundly spiritual.
“There’s
a social aspect, but we’re not an NGO,” Ralli said. “This is a
Christian work of charity, and that permeates everything, including the
way the doctors here take care of people. It’s not a mere doctor-patient
relationship, the doctor here is motivated by making himself available
by welcoming and listening to the patient.”
“There
are many people who came here with absolutely nothing, completely lost,
but with the help they received, not only the healthcare, but the
accompaniment, the word of encouragement, they were able to take their
lives back into their own hands, and faith helps a great deal.”
“The
charity our volunteers share is not mere philanthropy,” said Marín,
“it’s all for free, without looking at the clock or asking for anything
in return. And many of them get this strength out of prayer and the
Eucharist. Their charity is a prolongation of what they receive in the
altar, it’s the love of Christ that identifies us as Christians.”
Ralli
said that while the clinic doesn’t offer any specific spiritual
assistance, there is a group of 12 deacons who work in the dicastery to
provide that kind of accompaniment.
“The deacons work
at the listening desk, in which people come asking for all kinds of
help, not only healthcare, but financial assistance or simply someone
that listens to them, or for spiritual accompaniment. So the deacons
serve as a first contact, as a welcoming presence.”
“Saint
Augustine said that Christ is present in the poor, so accompanying them
and caring for them is not a mere act of charity, but an encounter with
Him,” Marín added. “God’s way necessarily leads through the way of
those in need, whatever their need may be: whether it be bread or the
Word. The option for the poor is the concrete face of love.”
“Deep
inside, the Christian person opts for the poor because he opts for
Christ. If we exercise charity by looking at the eyes of the one who
suffers, we return to them their dignity. The place where the poor are
cared for becomes a site of sacramental encounter with Christ, where we
enter into a relationship with the suffering Jesus. In this way, this
service is not only human but also a profoundly spiritual act,” Marín
added.
Ralli explained that it mostly functions financially through donations.
“We
have many donors. This is a beautiful thing, because charity is always
beautiful, and beauty attracts those who want to collaborate. Charity is
a chain: I see what you are doing and I want to help you, by donating,
by doing a fundraiser, by donating an instrument,” Ralli says.
“Every
instrument in the clinic was donated. For example, the new ultrasound
machine, which arrived a few months ago, was donated by the President of
Malta during a visit to the Holy Father. Instead of bringing any other
gift, the president wanted to make a gift for the poor,” he added.
The first patient to use the ultrasound machine was an unexpected surprise.
“This
machine weighs about 440 pounds so instead of bringing it up to the
Apostolic Palace so that the pope could see it, they brought it directly
to the clinic and we started using it. Turns out, the first patient to
come that morning to have an ultrasound was a lady from Chiclayo,” Ralli
said.
“So, afterward, we took the picture and the
president was able to present the picture and tell the story to the Holy
Father during the audience,” he added.
“Ambassadors
usually come and meet with the prefect and ask how they can help and
sometimes we ask for equipment for the clinic. The radiology equipment
was also donated by an institution that also contributed to the expenses
for the renovation of the San Martino clinic. We recently received a
probe for an ultrasound machine for endovaginal and endocavitary exams
that was bought through a fundraiser by a local association”, he said.
Ralli
also said that medications are one of the clinic’s most significant
expenses, but they’re able to receive many through the intercession of
the Banco Farmaceutico, an Italian foundation.
While
they’re able to provide their services with donations, Ralli says the
clinic also makes an effort not to waste money by overlapping its
services with the Italian public healthcare system.
“We
care for everyone, but we try to avoid overlapping with medicines. If
one of our patients is enrolled in the Italian healthcare system and has
a legal exemption, they can receive medicines, even expensive medicines
for free. Just to name one example, if you have diabetes, you can get
insulin for free,” he said.
“So, we’re careful to
avoid paying for a medicine someone can get free of charge at a
pharmacy. It would not make sense to spend i.e.100 euros on a medicine
if that person can get it by going to the pharmacy.”
Ralli
says he’s aware that in many cases people don’t know they have the
right to get these medicines for free or are too afraid to ask.
“That
happens often. In that case we assess the situation: we explain that
the person can have the exemption that allows them to get the medicine
for free, we accompany the person, we help. We have many general
practitioners who collaborate with us to sign off on the exceptions.
Naturally, these are not procedures that can be completed in five
minutes; so in the meantime we accompany the person, support the person
and provide the care he or she needs until he or she can exercise that
right in Italy,” Ralli added.
The clinic has grown
progressively with each passing year, both in space and in the variety
of services it offers. Asked if he sees the clinic growing in the
future, Archbishop Marín de San Martín said that “it’s not only
desirable, but necessary.”
“Our clinic has grown
enormously in the last few years, going from a handful of doctors that
kept the clinic open once a week, to 120 volunteers today and 2,000
patients per month. We trust in God’s providence, that continues acting
through the generous heart of so many benefactors,” he said.
“Our
first step forward, however, lies in faithfulness to the Gospel and in
communion with the Lord, who sustains the volunteers’ service each day.
As part of this process, we will also seek out the appropriate
opportunities for our service—with interest, patience, and
perseverance,” Marín concluded.
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