Pope Leo began an emotionally charged tour of South America on Friday, returning to the continent that helped shape his priesthood just three weeks after he underwent lung cancer surgery. The 71-year-old head of the Catholic Church will spend 12 days visiting Uruguay, Argentina, and Peru in what is described as one of the most intense papal foreign trips in decades.

Speaking to reporters on a plane before landing in Uruguay, Leo stated, “I’m very happy to be here,” and expressed a desire to bring a “message of hope in today’s world.” Regarding his health, the leader of the world’s 1.4 billion Catholics said he was “in fairly good shape” following his surgery. He acknowledged that some people were doubtful about the trip occurring, but stated, “I had no doubt and was convinced that this trip had to go forward.”

The Vatican reported that doctors gave him the all-clear to travel and that no special medical measures were required beyond standard care.

Leo, the first US-born pope, also addressed the US midterm elections occurring this week. He noted that his mail-in ballot made history as the first pope known to vote in a political election, saying, “I’m proud to be an American and to exercise the right” to vote.

The pope, who holds Peruvian citizenship alongside his American nationality, spent almost two decades in Peru as a missionary. On Friday, he referred to Peru as “one of my many homes” and said he looked forward to seeing “old things, new things and most of all the people” there.

The itinerary begins in Uruguay, a wealthy and secular nation where 5,000 police officers and 1,000 soldiers have been mobilized for security. Leo will be driven along the waterfront promenade in Montevideo in a custom-made Popemobile before meeting left-wing President Yamandu Orsi to receive the keys to the city. Cardinal Daniel Sturla, archbishop of Montevideo, noted there was “widespread interest in the pope’s visit that goes well beyond the confines of the Catholic Church,” reporting that tickets for masses in Paysandu and Florida sold out quickly.

While Uruguay is at odds with the Church over abortion, euthanasia, and same-sex marriage, Leo is expected to appeal for the protection of life and traditional family values. He may also discuss mental health during a visit to the impoverished and violent Casavalle neighborhood.

On Sunday, Leo will travel to Argentina, the homeland of his predecessor, Pope Francis. Leo stated on Friday that he would visit Argentina “with great joy,” noting it was the country where Francis “did not manage to go.” Vatican expert Christopher White described the trip as a double homecoming, stating, “History’s first Latin American pope, Francis, never returned to his homeland. Leo, a Peruvian citizen, now carries forward that mantle and legacy.”

The tour concludes in Peru on Wednesday. Leo described his arrival there as “a moment full of symbolism and emotion.” The country is currently experiencing "pope fever," with vendors selling themed merchandise, bakeries selling Leo bread, and inmates in a women’s prison crafting dolls in his likeness. A 14-metre (46-foot) statue of the pope has been erected in Callao. The final leg of the trip includes the Amazon rainforest and the former Inca capital of Cusco, as well as a return to his former life as Robert Francis Prevost, including a supper with priests from his old diocese of Chiclayo and a visit to a chapel he helped rebuild.