Arriving in the Vatican City State through one of its side entrances, one can find a set of unassuming wooden doors with a little hand-stitched sign reading “Dispensario Santa Marta.”

The doors open to an entire health complex which, though far from being a hospital, cares for hundreds of children every year, with doctors, dentists, psychologists, pediatricians and even lawyers who help parents navigate Italy’s complex legal system.

On Sunday, Pope Francis chose to celebrate his birthday with the children and families cared for by this facility, which marked 100 years last May. It has become an unwritten tradition that between Dec. 17 (the pope’s actual birthday) and Christmas, they are guests of honor in the Paul VI Hall, across from Santa Marta, both the clinic and the nearby residence where the Argentine pontiff has lived since being elected in 2013.

Run by the Daughters of Charity of St. Vincent of Paul, the current head of the clinic is Sister Antonietta Collacchi. Founded by Pope Pius XI to help Rome’s homeless population, the center today assists mostly migrant children, such as 22-month-old Sarei and Lida from Cameroon. Their mother, Brigitte, arrived in Rome with a student visa – she’s studying to become an electrical engineer – and when she got pregnant with the twins, she was uncertain how to regularize their situation.

“A friend guided me to Santa Marta, and here we are now!” she told Crux Sunday. The twins, wearing pristine red outfits, including a Rudolf cardigan with a nose that lit up, are too young to be left unsupervised, so they were sitting with their mother and her cousin, an economist with a master’s degree in international cooperation, instead of being close to the pope.

Most of the several hundred people who took part in Sunday’s event are foreigners with an unclear legal status, nor are their education levels generally as high as the cousins from Cameroon. In most cases, parents work in cleaning, construction and delivery. This is the case of Elisabeth, who came to Rome from Peru with her two children and her husband. Once in Rome, she gave birth to Maximiliano, who, on Sunday, appeared more interested in eating his cracker and drinking his bottle than being among those who gave Francis a birthday cake.

“We were doing fine, until the first lockdown due to the coronavirus pandemic,” Elisabeth told Crux. “We were caught unprepared, not having been able to stock diapers, formula and clothes for Maximiliano. Thankfully the clinic opened its doors, and they gave us everything we needed.”

“Things are looking up now, but I honestly do not know what we would have done without the clinic and our parish, they helped us more than I can ever thank them for,” she said.

Sunday’s event was lacking the usual pomp one would expect to find at a Vatican event. There was only one cardinal in sight – Polish Cardinal Konrad Krajewski, head of the Vatican charitable office that supervises the Santa Marta Foundation, along with a handful of ambassadors to the Holy See.

Often called “the pope’s charitable arm,” Krajewski was seated at the right side of the pope, with Collacchi to his left.

Across from them were children of all ages and backgrounds, from those who have benefited from the clinic to those whose parents have donated time to help those who cannot afford healthcare, even in a country such as Italy, where public care is free for all legal residents.

Several of the volunteers present- all seating in the last rows, acknowledging that the celebration was not for them – said Collachi had virtually infused the fear of God in them to convince them into lending a hand.

“It is very, very hard to say no to her,” one of the volunteers said, laughing. “Whenever I think about telling her ‘I am done’ I feel like I’m literally telling God that this is it. Then again, I guess it is true, right? What you have done for the least of these you have done for me …” she added, in reference to Matthew 25:40.

Among clowns, magicians, a mask-less pope greeting many of those in attendance personally, there was little to no time for formal speeches. Dr. Frabrizio Michelan thanked Francis for once again choosing to celebrate his birthday with them.

“The clinic gives support, reception, medical aid and economic support to every family that comes our way, without distinguishing among religions, with the generosity that identifies the Holy See and any Christian,” he said.

“Each volunteer, according to their capacity, profession and time, is at the service of others, without asking anything in return,” Michelan said. “Though I must admit, the smile we get in return is oftentimes something money cannot buy.”

Those who volunteer, he said, “do so with a generosity guided by Christ, who was so generous he gave his life for us.”

When the time came for Francis to address the children, he had only one message he wanted to drive home, and he did so by requesting them to repeat it over and over: “Listen to people, as this allows us to understand what they need and gives us the possibility of helping them.”

After birthday cake and games, the children, accompanied with their parents, had the opportunity to go through an inflatable “Christmas village” where they were gifted new jackets, toys, lunch, and the perfect Italian Christmas desert: a panettone for the grownups, and a jar of Nutella for the kids.