It’s an early Thursday morning in Gorakhpur, a small town in the northern Indian state of Uttar Pradesh at the end of the train line from Delhi. Father George Kalladanthiyil, C.S.T., has just finished his meditations with the 30 young seminarians who live at St. Joseph’s Syro-Malabar Catholic Seminary. He walks toward an outdoor altar where all is still, except for the sound of a light wind and the cawing of crows. A statue of the Virgin Mary guards the altar in the grotto, formerly part of an old train switching station abandoned by the British more than a century ago. Enveloped in orange garlands, which were placed by local villagers, the statue also guards two graves. One bears the headstone of a man who died in the prime of his life, Father Joseph Thoomkuzhy, C.S.T., who, we learn from the headstone, was born in 1959, professed as a religious in 1977, and ordained a priest in May 1986. He died in July of the same year.

The priest’s death was not remarkable. It is why he died that lights the fire in Father George’s eyes.

“He had an allergic reaction to the penicillin he took for a cold he had that summer,” says the priest who runs the daily operations of the Syro-Malabar Diocese of Gorakhpur and vividly remembers the new young priest.

“If we had had our hospital here at that time, this would not have happened. This was one of the reasons we built it.”

“Today, the Diocese of Gorakhpur runs a hospital, clinics and a variety of social work services, programs staffed with well-educated doctors, attorneys and social workers who bring professional assistance to a region in need.

The Diocese of Gorakhpur encompasses some 11,000 square miles, stretching north to the Nepal border and east to the state of Bihar. In this densely populated area, more than 85 percent of the total population of 13.5 million people profess Hinduism; the rest follow Islam. There was no formal Catholic presence in the region until 1970, when members of the Little Flower Congregation, a Syro-Malabar community of priests from India’s southern state of Kerala, began to minister to the needs of the people.

In 1984, the Holy See erected the Diocese of Gorakhpur, entrusting it to the care of the Little Flower Congregation and naming Father Dominic Kokkat, C.S.T., as its first bishop. Under Mar Dominic’s leadership, the diocese operates 2 parishes, 20 mission stations, 24 convents, 17 primary schools, 7 high schools, two maternity clinics, 11 clinics, 183 educational programs and 45 health education centers. “These community-based programs give this sleepy Indian outpost near the Nepalese border much-needed services, offering the hopeless a better chance of survival in a world of poverty that has remained unchanged for a millennium.

Survival starts first with health care, a service that had been the sole domain of the rich until the diocese opened Fatima Hospital in 1995. The Gorakhpur area is rife with diseases that doctors in developed nations seldom treat today: leprosy, cholera, dysentery, malaria, viral fever, jaundice, encephalitis, tuberculosis and polio. Recently, an outbreak of filaria, a mosquito-transmitted bacteria that attacks and painfully swells the testicles as elephantiasis might billow a leg, threatened these flood-plagued villages dependent on water from stagnant wells, polluted rivers and slow streams.

Until Fatima Hospital was built on the outskirts of Gorakhpur, villagers had to walk for miles to a few rural dispensaries for what meager care they could obtain. There, only untrained health care workers could be found to treat all the emergencies in a clinic lacking adequate medicines, instruments and beds. Fatima Hospital now has 25 beds. Rooms for 60 more beds are under construction.

“Here, people don’t go to the hospital,” states Father Jose Manjiyil, C.S.T., a lawyer who is the director of the hospital.

“We have to find them, collect them and give them medicine forcefully. We see this problem with polio. There is lots of polio here. Getting people to participate in any vaccination program or to take pills to prevent these diseases is difficult, very difficult.”

Father Jose explains how, in the past, the sick would not use the government hospital, where treatments were extremely expensive and inadequate.

“One of our priests died because we did not have a good hospital to which to take him. If you go to the government hospital you will not get treatment,” he continues.

Fatima Hospital has 39 health care providers, including seven full-time doctors, three on call, plus five religious sisters who are nurses and twelve dispensary attendants. A cardiac physician comes three times a year from Delhi. Sister Candida, a Missionary of St. Joseph, administers nursing operations and notes the need for more facilities: “We pray it will get bigger.”

When we visited, most of the beds were empty – it was harvest time and all available hands were needed in the field. The maternity ward, however, bustled with deliveries.

In the waiting room a few women with young children waited to be seen. One woman complained of stomach pains and pains in her joints. A picture of Mother Teresa hung on the wall above her.

“We see mostly diarrhea, tuberculosis and malaria,” reports Dr. Vinay Sinha, one of the doctors doing intake that day.

“Nothing to be alarmed about. We give them medications and cures. Most who come are poor and cannot go anywhere else. First we admit them and then we treat them. The care is good here and the cleanliness is very good. I think it is the number one hospital in Gorakhpur.”

At 9:30 A.M., nurses and patients line up in front of a statue of the Virgin Mary encased in glass in the lobby hall. It is time for prayer, and participants are given hymnals in Hindi. In a district, however, where the average literacy rate hovers at 36 percent, 18 percent of which are women, the books are held and perused but not read.

The lines form by gender, four men and a dozen women. A sprightly young boy named Lal, recovering from the amputation of his leg due to a bone infection, hops around between his caring father and the doting nuns. Sister Candida starts the prayer and leads the hymn. A woman in the line rocks her young infant, who has been decorated with amulets around his neck, including a tiny medal bearing the profile of Jesus.

“In villages, speaking about God is not allowed, because the people are Hindus,” says Father George. “Many of the Catholic rituals we see practiced become a mixture of both religions. You see this with the statue of the Virgin Mary in the garden. The villagers come to worship her and put garlands around her neck.”

“At the moment,” writes Mar Dominic, “we do not aim for an increase in the number of Catholics. Jesus began his apostolate teaching and healing. The first step of evangelization is humanization: to bring up the people to the level of a dignified life is evangelization in its fullest sense.”

In the hospital wards, women rest after giving birth. One woman cries after having a cesarean for twins. One child died and the one that survived, a girl, sleeps in her mother’s arms. The boy died and his mother is mourning his death.

“They do not like girl babies a lot,” explains Sister Candida. “It is a Hindu custom that after a week they say a prayer and the boy will get new clothes. The girl gets nothing.”

Giving birth at Fatima Hospital is not free. Normal births cost 250 rupees (about $6) and cesarean births cost 1,500 rupees (about $33) – a costly expense. The standard wage is 45 rupees a day, or one dollar.

The hospital has one ambulance, although the road is rough and crowded even in the best of conditions. One expectant mother and her aunt had to come from 47 miles away and managed to ride in with the postmaster. Most of the patients are cared for by a family member, who must also be responsible for feeding the patient.

“At private hospitals the work gets done by threat,” reveals Father Jose, “but here we motivate our workers. We work with them and tell them their duties. We have seen workers that may treat patients physically but kill them mentally.

“A simple man will have to pay 4,000 rupees ($89) in a government hospital where he might not see the doctor once,” the priest continues. “People come here and we treat them as human beings, whereas in other private and government hospitals people are treated according to their status in society and what they can afford. Here, it’s service first. All are equal. Patients may not get air-conditioning or endless nursing care, but they will be admitted and they won’t be neglected.”

In the dispensary, the shelves are well stocked in alphabetical order, mostly with antibiotics. There are elixirs for stomach disorders and aspirins for headaches, but the pharmacist admits that the drugs are not first-rate and the hospital is forced to make do with less expensive substitutions. They are given free of charge to those in need.

Young Lal hops his way back to the room he shares with Vijay, a 10-year-old boy who was stricken with polio. He lies in a pretzel position on an adjacent bed, smiling and amused by the company around him. Doctors have operated to straighten his limbs. He needs more surgery.

“The problem we face is poverty,” says Father Jose. “You know it, but you don’t feel it. If you ask a mother to add just one more spoonful of medicine to help a child, she will answer, ‘How can I? Where should I get it?’

“You can feel that poverty when you go to the village. We say you have to do this or that to prevent a disease and, if the people are poor, we will give them the medicines. But you still have to get them to want to do it.”

Diocesan social workers go from village to village to offer health care and teach villagers basic hygiene. They teach mothers natural methods of family planning and administer immunization programs; the task is gargantuan and, at times, frustrating.

“Our goal is empowerment,” says Father Jose, “to teach people how to keep clean and treat problems at home.

“Rather than offer welfare, we are taking an empowerment approach, which demands the participation of the people. The reaction has been positive and the more villagers learn about this, the more they want to know and participate.”

In the village of Dumrikhas, located about an hour’s bumpy drive from the din and dust of Gorakhpur, Sister Lena, a nursing sister from the Society of Helpers of Mary, plays doctor, midwife, nurse, handholder and mother to the many villagers who walk miles to the clinic and dispensary she runs at the mission station. Her log book shows 2,000 general patients a year. She can count on an average of 10 deliveries per month when she is not treating such symptoms as stomach pains, vomiting and infectious swelling.

Every Wednesday is vaccination day in the village, when villagers can get protection from polio and tuberculosis. Sister Lena is adamant about seeing more mothers and babies.

Sister Lena’s work covers 30 villages, and if the villagers won’t come to her, she goes to them, administering polio vaccines and conducting sanitation seminars.

“We have meetings for the ladies,” she reports. “We teach them about hygiene and what to do about things like diarrhea. We give them medicine for scabies and show them how to treat these diseases.”

The electric fluorescent bulbs that light the clinic go out, but Sister Lena is prepared and lights a candle. In the candlelight a tour of the clinic reveals a gurney table with a depression for blood and beyond that a room with six empty beds.

“That is the lying-clown room,” Sister Lena explains, “but the women never stay long. They get up after they give birth and walk back to their villages with their newborn babies.”

The medicine shelves were sparsely stocked. Sister Lena discussed the miracle of having funds for a quarter of the expenses the clinic incurs every month, but still managing to work the clinic and save lives.

“We struggle because of the lack of money, but we cannot send away people who are in pain,” she says.

“We light this candle a lot and say it is the light of God and that God is a better doctor. People come here with their faith and there is result. They get healed quickly. They go to many doctors, but we pray for them and with one dose of medicine they are cured.”

Lark Ellen Gould, a Los Angeles-based writer and editor, has covered stories from Asia and Africa for more than 15 years.