Until 2004, when construction on Jyothi Hospital began, the residents of Belthangady — a heavily forested township in the southern Indian state of Karnataka — had to travel about 40 miles over poorly maintained roads for any serious medical care. For minor ailments the local government hospital — really little more than a clinic — sufficed, but for more complicated procedures the unavailability of prompt treatment sometimes proved deadly. Infant and maternal mortality rates, as well as miscarriages, were high.

When Mar Lawrence Mukkuzhy, Syro-Malabar Catholic Bishop of Belthangady, invited the Sisters of the Destitute to open a hospital, it was reasonable to believe the local residents would welcome it. The situation proved more complicated, however.

There are only 21,500 Catholics in the eparchy, which comprises three civil districts with a total population of 3.2 million people, the vast majority of whom are Hindu.

The eparchy also includes a large number of adivasi, tribal peoples living in remote, self-contained communities who eke out meager livings as hunter-gatherers.

In addition, Belthangady, despite its small size, has significant religious importance: It is home to Dharmasthala, a temple town that attracts millions of Hindu and Jain worshipers. In that sense, it is a welcome sign of religious tolerance: a holy site shared by two faiths.

But many local residents were not happy to see an increased Christian presence, even if confined to a hospital. This was made apparent in 1999, when Mar Lawrence began to build a small church near Dharmasthala. Local Hindus protested and, for a while, thwarted the construction effort. Lord Shiva, they said, would be offended by the presence of another deity in the area.

Then, one night during a storm, lightning struck the 40-foot-tall statue of Lord Bahubali, Dharmasthala’s centerpiece, damaging the head of the Jain deity. According to custom, the local community approached a respected astrologer to determine the reason behind the incident. “Their god is more powerful than ours,” he said. “You shouldn’t prevent those people from building a temple for their god.”

The church was built eventually, paving the way for other projects in the area.

“This incident really helped us to construct a new hospital here,” Mar Lawrence said. The bishop had invited the Sisters of the Destitute — founded in 1927, the first indigenous community for Syro-Malabar Catholic women — to build the facility on four acres of land he had reserved for the purpose.

“The bishop delivered wholehearted support to us in every process,” said Sister Mercitta, hospital administrator, “from the construction of the building to the purchasing of diagnostic apparatus.”

Jyothi (or light in Hindi) Hospital opened with 25 beds, but it has doubled its capacity over the past two years.

The hospital’s 10 Sisters of the Destitute do the bulk of the work. Not only have the sisters each completed nearly 10 years of religious formation, they also have extensive medical training — health care is one of the primary ministries of the sisters, who number more than 1,000 throughout India.

With a small staff, multitasking is essential. Sister Ann Maria, for example, is convent superior, cook, gardener and X-ray technician. Including the sisters, the hospital team consists of 12 doctors, 18 nurses and 6 support staff.

The hospital has X-ray machines, a computed tomography scanner, intensive care units, ultrasonic imaging devices, incubators and lab facilities — technology unfamiliar to many local residents. Much of the sisters’ early work was spent in the field, educating residents about the new treatments.

“They were totally unaware of modern medical facilities and treatment,” Sister Mercitta said. “We conducted medical camps in the villages and tribal areas. Most of the people were afraid of being tested with modern medical equipment.”

The goal of the bishop and sisters was not only to offer advanced medical treatment to its residents, but also to ensure that such treatment was affordable. “We don’t charge patients who are treated in the general ward,” Mar Lawrence said. For other procedures, patients are charged according to their ability to pay. Most procedures — CT scans and lab tests — cost 50 percent less at Jyothi Hospital than they would at private hospitals. (To help meet the hospital’s financial needs, the sisters planted rubber trees on the hospital grounds. They also rely on their vegetable garden for many meals.)

Those too ill to make it to the hospital are able to receive checkups and treatment during the staff’s many field visits. “Between 250 and 500 people attend our medical camps,” said Sister Ann Maria. “The malaria detection and treatment camp is frequently held; malaria is a common disease in the area.”

“I’ve worked in many hospitals, all of which conduct free medical camps,” said Jyothi Hospital’s Dr. Santhraj Sequera. But, he continued, most hospitals conduct the camps to win new patients and withhold treatment until a patient pays a hospital visit. Jyothi Hospital is different. The hospital’s staff dispenses treatment and medicines whenever and wherever it is appropriate.

“They are really working for people who are in need,” Dr. Sequera said.

Today, Jyothi Hospital serves 60,000 people in the Belthangady area — irrespective of caste, creed, sex or age — working closely with local parish priests to assess the medical needs of different communities. The sisters, with Mar Lawrence’s support, are contemplating opening a nursing school.

“But if we start one, it will take a lot of time and may divert our attention from the hospital,” Sister Mercitta worried.

For now, it is their medical work at the hospital and in the field that commands the sisters’ attention. They recognize the value of this work every time they visit a patient.

It is more than the promise of medical relief that the sisters bring, said Sister Dr. Lissy George, a pediatrician.

“Our patients believe that God blesses them through us. Our presence makes them optimistic.”

A photojournalist, Mercy Sister Christian Molidor is special assistant to CNEWA’s secretary general. Jomi Thomas is a staff writer for CNEWA’s Ernakulam office.