CHARITY IN COTTONERA: A LEGACY OF CARE, COURAGE & COMMUNITY

The Power of Faith and Philanthropy

In the centuries before Malta had state welfare, healthcare, or pensions, the burden of caring for the poor, sick, and elderly fell largely on the Catholic Church, religious orders, and a few generous individuals. Particularly in the Grand Harbour towns, where the population was high and living conditions were tough, charitable institutions became a lifeline for many. The Knights Hospitallers, although originally based in Jerusalem and then Rhodes, left an indelible mark on Malta. Their mission of care extended beyond knights and noblemen to all people, regardless of race or creed. Even Muslims and slaves were treated at their hospitals—though often in separate wards.

St Anne’s Hospice, Senglea

Another charitable institution in Cottonera was the St Anne’s Hospice in Senglea, founded by Nicola and Maria Cornelia Dingli in 1794. Built after Maria’s death, it opened in 1817 and offered refuge to elderly and needy women, especially from Senglea and Siġġiewi.

It began with just six beds and was managed by the Bishop of Malta. In 1880, the Tertiary Franciscan Sisters took over, running the hospice with care and dedication until 1984. The post-war years exposed the building’s limitations, leading to its demolition in 1980 and the construction of a new, modern hospice on the same site. St Anne’s Hospice reopened in 1987, accommodating 33 residents. It remains one of the most enduring charitable institutions in Cottonera.

District Medical Service in the Three Cities

By 1725, a state-run District Medical Service consisting of a state-paid doctor and surgeon was formally introduced, bringing free house calls to sick poor women in Valletta and the Grand Harbour towns, including Birgu, Bormla, and Isla. These medical professionals assisted in childbirth, and distributed food and medicines. Later, under British rule, these medics also administered the first vaccinations and the system  expanded into government dispensaries, known in Maltese as il-Berġa (from the Italian Albergo dei Poveri). These dispensaries remain part of the healthcare landscape today.

Foundlings, Orphans, and Girls at Risk

Abandoned infants—known as foundlings—were cared for by the Church and charitable institutions. In Cottonera and elsewhere, infants born out of wedlock or abandoned due to poverty were sometimes left at foundling homes. A rotating cradle—known as the ‘ruota’—allowed babies to be anonymously deposited through a hospital wall. In Valletta and Mdina, these children were cared for by wet nurses.

From around the age of 8, boys were apprenticed to learn trades, while girls were sent to conservatories, such as the one in Bormla or the ‘Conservatorio de’ Vergini’ in Floriana, where they learned household skills and worked in textiles. Every year, a few girls were granted dowries of 40 scudi—paid from the cotton profits—to marry or begin a life of independence. This system helped reduce poverty, provided vocational training, and protected vulnerable girls from abuse or exploitation.

Private Giving and Religious Fraternities

Beyond the large institutions, religious confraternities played a major role in Cottonera’s social fabric. Membership ensured basic medical help, burial services, and spiritual support. These organisations were run by artisans and working-class people, who contributed small fees throughout their lives to qualify for aid in old age or during illness. They also hosted prayers, funerals, and Masses for the deceased, provided support to widows, and offered communal burial rights—all of which were considered vital for dignity in death and beyond.

Examples of this were the Confraternity of St Joseph in Birgu, which had a similar mission of religious and social support, including assistance to the sick and even aid to those condemned by justice, such as providing a proper burial; and that of Our Lady of Charity in Birgu as well, which, as its name testifies, carried out many works of charity for those in need.

National Context and Broader Charity Efforts

While Cottonera had its own vital charitable structures, these functioned alongside a wider network of institutions across Malta that served as models or collaborators in the development of organised welfare. One of the earliest examples of women-focused charitable care was St Peter’s Hospital in Mdina, established before the 15th century. In 1418, it was transformed into a Benedictine monastery, making it one of the earliest spaces where religious women took responsibility for health and moral care.

Meanwhile, the Santa Spirito Hospital, just outside Mdina, had already been functioning since 1372. By 1433, it housed at least eight permanent poor or sick residents (referred to in Latin as infirmorum et pauperum habitanti poviri). Between 1494 and 1548, records show that Santa Spirito covered not just medical care but food, shelter, clothing, and even burial for its residents. After 1550, the hospital continued to support the poor, though it seems meals were no longer provided regularly. Still, it remained a refuge for the infirm and destitute well into the modern era.

Meanwhile, the Santa Spirito Hospital, just outside Mdina, had already been functioning since 1372. By 1433, it housed at least eight permanent poor or sick residents (referred to in Latin as infirmorum et pauperum habitanti poviri). Between 1494 and 1548, records show that Santa Spirito covered not just medical care but food, shelter, clothing, and even burial for its residents. After 1550, the hospital continued to support the poor, though it seems meals were no longer provided regularly. Still, it remained a refuge for the infirm and destitute well into the modern era.

In the 1590s, financial aid was also distributed by the Università (local municipal councils), particularly to the aged and especially to penniless widowed women in central Malta. Such support often came in the form of bread, soup, and occasionally money. By the late 18th century, the Sacra Infermeria in Valletta had become the best example of charity-driven medicine. In 1776, it was distributing bread and soup daily to the poor and infirm of the city. It also maintained around 50 ‘perpetual beds’ for men in need—beds reserved for life—along with direct financial assistance.

The Ospizio and State-Led Welfare

While Valletta and Floriana housed Malta’s largest government hospices—like the Casa di Carità (later the Ospizio)—Cottonera residents also benefited from state support. In times of severe need, aged or infirm men from Cottonera might be sent to the Floriana Ospizio, especially if they lacked family support.

The Ospizio in Floriana

This move was often temporary. During summer, some residents were discharged with a daily allowance to reduce crowding and limit the spread of disease. Although these institutions provided shelter, food, and medical care, they were often feared. Overcrowding, illness, and forced separation of elderly couples made them a last resort. Yet for many, they were a lifeline during desperate times. As such, families sometimes opted to send just one parent—usually the man—for seasonal care, returning home when possible.

Meanwhile, in towns like Birgu and Bormla, older men could be found offering services as guides, porters, carriage drivers, or even coffee shop helpers, working for small change or food. Aged women ran lodging houses, sold goods in the street, or worked as healers, midwives, or informal traders. Many elderly residents of the Grand Harbour towns engaged in semi-formal survival strategies, including bartering and borrowing food on credit. Activities like pawning clothes, trading homemade remedies, and even witchcraft or begging were part of everyday life, specially on the steps of Valletta’s Nix Mangiari, but also echoed in Cottonera’s alleys and squares.

Government Kitchens and War-Time Relief in Cospicua and Kalkara

Hardship during World War I hit working-class families in Cottonera hard. Unemployment, food shortages, and inflation made daily survival a struggle. Cospicua became a centre for relief efforts, including a Government Kitchen opened in January 1918, which served approximately 200 bowls of soup daily for just two pence. In Kalkara, residents faced crop theft and food insecurity. The Unione Cattolica San Giuseppe, a mutual help society, appealed for action against bread prices. Meanwhile, the Church launched the Archbishop’s Bread Fund, with churches across Cottonera collecting weekly donations to buy bread and soup tickets for the hungry.

Despite foreign aid flowing to wounded soldiers during the war, the local press reminded readers that Maltese children in institutions also needed support. This led to fundraising events, church appeals, and charity concerts. The ‘Society of St Vincent de Paul’ distributed more than 138,000 bread tickets and 65,000 loaves of bread to struggling families in 1917 alone. During the Second World War Victory Kitchens were also opened in Cottonera and ration cards introduced to gain access to essentials, although those who worked in the NAAFI (navy, army & airforce institutes) and Dockyards had better access to food, either through their work rations or what they managed to pilfer. Poorer folk were reduced to selling whatever they possessed on the black market in exchange for food or resorting to the ‘Gaxin’: food scraps and leftovers from British military messes, sold wrapped in newspapers for a shilling.