The tone for the high stakes, four-day summit was set at the start, with victims from five continents — Europe, Africa, Asia, South America and North America — telling the bishops of the trauma of their abuse and the additional pain the church's indifference caused them.
"Listen to the cry of the young, who want justice," Francis told the gathering of 190 leaders of bishops conferences and religious orders."The holy people of God are watching and expect not just simple and obvious condemnations, but efficient and concrete measures to be established."
Francis called for specific protocols to handle accusations against bishops, in yet another reference to the McCarrick scandal. He suggested protocols to govern the transfers of seminarians or priests to prevent predators from moving freely to unsuspecting communities.
One idea called for raising the minimum age for marriage to 16 while another suggested a basic handbook showing bishops how to investigate cases.
Abuse survivors have turned out in droves in Rome to demand accountability and transparency from church leaders and assert that the time of sex abuse cover-ups is over.
"The question is this: Why should the church be allowed to handle the pedophile question? The question of pedophilia is not a question of religion, it is (a question of) crime," Francesco Zanardi, head of the main victims advocacy group in Italy Rete L'Abuso, or Abuse Network, told a news conference in the Italian parliament.
Inside the summit hall Thursday, the church leaders heard five videotaped testimonies from victims about their abuse and cruel treatment from an indifferent hierarchy.
One woman from Africa told the summit that the priest who began raping her at 15 forced her to have three abortions over the following 13 years.
"He gave me everything I wanted when I accepted to have sex; otherwise he would beat me," she said. The victims' names were not released to protect their privacy, but Chilean survivor Juan Carlos Cruz confirmed he provided a video.
"You are the physicians of the soul and yet, with rare exceptions, you have been transformed — in some cases — into murderers of the soul, into murderers of the faith," Cruz said in his testimony.