The Sovereign Military Order of Malta may be well known for its ceremonious activities and its pomp, but when the cape is removed the Order’s true nature, that of Hospitallers caring for the sick, is revealed.

Back in 1113 AD, the organisation was recognised as a religious Order by Pope Paschal II. The Order originally provided refuge and medical aid for Christian pilgrims en-route to Jerusalem. It later became the Military and Naval Order that achieved fame for its defence of Malta from the Ottomans in 1565.

In truth, the Order today has very much gone back to its origins, offering medical aid and helping the poor all over the world.

Marchesino Daniel de Petri Testaferrata, who was elected President of the Maltese Association of the Order of Malta last June, told The Malta Independent that it works in 120 different countries. “There are 13,500 members world-wide, plus 80,000 trained volunteers and 25,000 medical and para-medical personnel, working in a large number of hospitals, hospices, homes for the elderly and a variety of other aid activities.”

The Marchesino said that the Order operates in a similar way to other large organisations, but while some of these can call on strength and international funding, the Order makes use of its international credentials and its sovereign entity. As it is subject to international law, it has diplomatic relations with numerous countries and uses these to better assist the sick and the poor. For example, the Order might be able to go into places where other organisations would experience significant difficulties.

“The Order can call on very highly trained personnel who know how to go in and immediately provide assistance, how to gain access to the toughest situation. It was one of the first organisations to help after the devastating Haiyan typhoon in The Philippines, and has been active in Myanmar for several decades. It is also active in places like Haiti, providing assistance to the most vulnerable.”

In Africa, projects by the Order focus on care for HIV-positive mothers and infants, treatment for malaria and tuberculosis, providing clean water and treating leprosy sufferers, while also running health centres and dispensaries in many rural areas.

In Asia and the Middle East, the Order cares for refugees, supports orphaned children and provides emergency aid after disasters. The list goes on and on.

Its work is not only carried out in the world’s poorer countries but also in Europe and North America. It ran reconstruction projects after Hurricane Katrina, it organises home visits for the sick and housebound, provides shelters for single mothers and those who have suffered domestic abuse and organises programmes to help displaced individuals and care for the young with drug addiction.

The Order is a lay religious organisation, and follows the motto ‘Tuitio Fidei et Obsequium Pauperum’ – ‘Defence of the Faith and Assistance to the Poor, the Suffering and the Sick’. It has diplomatic relations with over 100 countries – the majority of which are not Catholic and its sovereign status is quite unique. It has many of the trappings of a state, but lacks certain attributes such as, for example, territory. The Marchesino de Petri Testaferrata explained how this actually works to the Order’s advantage. “Without the necessity to protect its borders, the Order can really use its diplomatic credentials to focus exclusively on providing aid to those who really have nowhere else to turn to.”

Malteser International, the relief agency of the Order of Malta, has been active all over the world. A striking example is its activity within the Democratic Republic of Congo, where it has been present since 1994. Dr Alfred Kinzelbach, who was interviewed for the Order’s activity report magazine in 2013, said that in 1994 they began supplying clean water and medical assistance for the civil war refugees, and since 2006 have been taking part in medico-socio development programmes with the local Ministry of Health.

One of the most difficult problems to overcome, he said, is sexual violence, where “it has become an instrument of war, never seen at this level in any other part of the world. To use sexual violence as a strategic ploy creates shame and humiliation in the victims. But it has strong repercussions throughout the community too. The men see the rape of their wives and daughters as the definitive failure of their capacity to protect them. For women, the damage is doubled, because the consequence of having been blamelessly violated often leads to their social exclusion.”

The Malteser International Annual Report for 2014 notes that the Order of Malta sent medical supplies into regions affected by the Ebola crisis in 2014, and in 2015 it launched information campaigns to minimise the spread of the disease.

In 2014, the UN had five crises listed in its highest category for the first time in its history.

Dominique Prince de La Rochefoucauld-Montbel, the Grand Hospitaller of the Sovereign Order of Malta (the equivalent of its Minister for Health), explained that from to the medical aspect of things: “the Ebola epidemic showed quite clearly that we are unprepared for crises of that order of magnitude. At the same time, the worldwide increase in resistance to antibiotics and the increased mobility of populations makes controlling the spread of infectious diseases ever more difficult. There is a global challenge in front of us and all organisations definitely need to pull together on this.”

Looking ahead to the future, he explains that “an important part of our strategy for 2020 is first of all to strengthen our international networks, partnerships and coordination mechanisms – for example, as we did through our membership of the World Health Organisation’s Global Health Cluster. This would help us better deal with worldwide challenges. Secondly, we are continuing to develop our cooperation with local partners in projects on the ground while, finally, strengthening our focus on the areas of health and emergency relief.”

Turning to its work in Malta, the Order holds true to the aims of the international organisation. Marchesino De Petri Testaferrata spoke of one of the many activities organised for the sick in Malta. Every year, the Order organises a pilgrimage to Lourdes in which its members from all around the world fly a number a number of sick people to Lourdes on a spiritual journey. They use an Accueil – essentially a cross between a hospital and a hotel, where members of the Order who are medically trained are able to offer care for the sick during their pilgrimage. Other members volunteer to run the refectory, organise transport – the list goes on.

The Marchesino explains that the pilgrimage takes months of planning, with over 7,000 people joining the 300 Maltese participants in making the journey from around the world. “Lourdes is a place that creates a spirit of togetherness. It gives people who spend most of their time in hospital a chance to get out, yet still be cared for. It’s a spiritual pilgrimage, a chance for us to truly care for Our Lord through the sick – hence our use of the term ‘Our Lords the Sick’.”