The annual parade of the Black Nazarene atop a gilded carriage around Manila's downtown Quiapo district is one of the largely Catholic country's most spectacular and extreme shows of faith, and attracts people from all walks of life.

The carriage was pulled along in a sea of devotees, with thousands scrambling to get near the statue or touch the ropes as the image slowly made its way through busy roads.

Almost 400 people suffered injuries or other medical problems in the crush.

The faithful threw white towels or handkerchiefs to men at the front, who wiped them on the statue before tossing them back.

"I couldn't get near, but when I saw the Nazareno I immediately knew that my prayers will be answered," 59-year-old Linda Meme told AFP, tears welling in her eyes.

A mother of 10, the laundry woman and part-time faith healer said she wished for good health and that the youngest of her children, suffering from a digestive disease, could be healed.

She said she had not missed a Black Nazarene procession since the 1970s, and two of her adult children were also in the crowd.

The life-size wooden statue was brought to Manila by a group of Augustinian priests from Mexico in 1607, where it was first housed in a church at an old Spanish fortress, local religious historians said.

According to folklore, a fire aboard the Spanish galleon that transported the statue partially charred the image, leading to its dark colour, although the Catholic church has never offered any official explanation.

After more than a century, the image was transferred to the Quiapo church, where it survived two huge fires, two earthquakes and the bombing of Manila by allied forces to end the Japanese occupation in 1945.

Devotion to the Nazarene grew in the 19th century when then-Pope Pius VII declared that anyone who prayed piously through the image could expunge the punishment meted out for their sins, both in the here and now, and in purgatory.

The event's popularity has grown so huge that each year dozens are hurt and sometimes crushed to death in the crowd.

Members of the influential Catholic Bishops' Conference of the Philippines have cautioned against taking devotion to the statue to extremes, saying that the figure itself was only a representation of the miracles of God.

"The devotion we give to this statue should be properly understood. This does not have special powers, it's just a representation of our Lord," Bishop Deogracias Iniguez said over DZBB radio.

"When you believe it has special powers per se, that is when it becomes superstition."

The Red Cross meanwhile said nearly 400 devotees have been treated by medical staff, with injuries ranging from laceration, abdominal pain, sprain, headache, dizziness, difficulty of breathing and hypertension to back pain.

A 35-year-old man was in serious pain after suffering third degree burns to his feet, while another suffered bone fractures while trapped inside the moving mass of human bodies."

The Black Nazarene, known to devotees as Nuestro Padre Jesus Nazareno de Quiapo ("Our Father Jesus Nazarene of Quiapo"), is a life-sized, dark-coloured, wooden sculpture of Jesus Christ, held to be miraculous by many Filipino devotees. The Black Nazarene is currently enshrined in the Minor Basilica of the Black Nazarene in Quiapo, Manila, Philippines.

The Feast of the Black Nazarene is celebrated every January 9 with the weekly Friday Masses held in its honour beginning on the first Friday of the year.

Een voorbeeld van hoe geloof hier leeft in de Filipijnen. Meer dan ooit, want hoe armer de mensen zijn, hoe heviger zij zich vastklampen aan iets wat troost kan bieden. De troost is soms ver te zoeken in dit soort van processies, want men raakt gewond of wordt vertrappeld in de menigte.  Zakkenrollers zijn veeltallig aanwezig om te doen waar zij het best in zijn. Het is erg warm en echt een beproeving (al dan niet religieus) om door een onoverzichtelijke menigte opgeslokt te worden en doofgebruld te worden door een massa van schreeuwende en huilende kelen. De overgrote meerderheid gaat zich voor lange uren te buiten aan religieuze overgave en keert na afloop weer huiswaarts, al dan niet in de hoop dat er daarna iets in hun leven zal veranderen, bij voorkeur ten goede.