The scope of the tragedy at Lampedusa - with 111 bodies recovered so far and more than 200 missing, according to survivor accounts given to UN officials - has prompted outpourings of grief and calls for a comprehensive EU immigration policy to deal with the tens of thousands fleeing poverty and strife in Africa and the Middle East.
On a pilgrimage to Assisi, Pope Francis called the tragedy a "day of tears" and denounced a "savage" system he said drives people to leave their homes for a better life and turns a blind eye when they die in the process.
Lampedusa, a tiny island 113km off Tunisia and closer to Africa than the Italian mainland, has been at the centre of wave after wave of illegal immigration. The island's mayor, Giusi Nicolini, said she had hoped the pope's visit there earlier this year would draw attention to the issue and lead to policy changes.
Instead, the tragedy may prove to be the biggest loss of life involving migrants undertaking the treacherous journey across the Mediterranean, where such deaths are all too common and often are impossible to verify because bodies are lost far out at sea and never found.
"Here it is all within 600 metres of shore and we will have more clarity," said Laurens Jolles, the UN High Commissioner for Refugees representative in Italy.
More often, unseaworthy vessels limp to shore with many dead on board, including one recent incident with 63 bodies on a boat with seven survivors.
Remote and far from the Italian mainland, Lampedusa was ill-equipped to deal with such a staggering death toll: Four hearses arrived on an overnight ferry and caskets had to be flown in.
According to survivor accounts, the group of some 500 migrants who boarded the rickety trawler had been living together in the same building in the Libyan capital of Tripoli for three months. Almost all were from Eritrea and all had the same goal of reaching Europe, said Barbara Molinario, a UNHCR public information officer.
"They boarded the same boat and were at sea for two days. At 4 in the morning of the third day, they spotted land. They felt safe, because they thought they had made it. They saw the lights from land," she said.
But the boat's engine had died and they were trapped in a rocky bay where they couldn't land, Molinario said. A fishing boat passed, but didn't stop. It was unclear if those on board saw the migrants or were aware of their plight.
To draw attention to the distressed vessel, someone set a towel on fire. But many on board did not know the flames were intentional and panic ensued. People stampeded to one side of the boat, capsizing it and flinging hundreds of men, women and children, many of whom could not swim, into the sea. Molinario said many victims were trapped in the hull.
Efforts to reach the boat, now 130 feet below the surface, to search for more bodies were stymied by choppy waters Friday.
Reports that a boat did not help the stranded migrants prompted a Dutch lawmaker to call for an investigation. Some provisions of Italian law "effectively dissuade" boat captains from helping migrants in distress, said Socialist Tineke Strik, adding that no law should impede rescuing people whose lives are in danger.
Thousands make the perilous crossing each year, seeking a new life in the prosperous European Union. Smugglers charge thousands of dollars a head for the journey aboard overcrowded, barely seaworthy boats that lack life vests. Each year hundreds die undertaking the crossing.
On Tuesday and Wednesday alone, Italian authorities rescued 460 people from two boats off Lampedusa.
Conflict in Africa and the Middle East has led to a surge in such migrations, including many fleeing civil war in Syria, according to the UNHCR. Some 30,100 migrants arrived in Italy and Malta in the first nine months of 2013, compared with 15,000 in all of 2012.
The numbers are overwhelming Lampedusa's ability to respond. The island's migrant centre was built for 250; there are now more than 1,000 people there, including the shipwreck survivors. "Everyone else is sleeping on the floor, most of them outside, including women and children," Molinario said. "This of course includes survivors of yesterday's shipwreck."
Fiorino said the migrants he pulled from the sea had been stripped of their clothing, possibly by the current.
"They were covered in gasoline. I had a hard time pulling them out of the water because they slipped from my arms. We used every rag we had, every sheet, table cloth, towel, to dry them off and cover them," Fiorino said.
He estimated that the boat, which the migrants say was packed with 500 people, was no more than 20 meters long. "They were packed like sardines," he said. "They couldn't even move."
Fiorino, who has lived in Lampedusa since retiring as a woodworker near Milan several years ago, said islanders "have been living this situation for at least 30 years."
"In the last few years, it has become very heavy. But they are still welcoming, and they still try to help," he said.
- AP