To hear Father James Conard tell it, the first Catholic missioners to northern Tanzania near Lake Victoria in the early 1900s were welcomed by a swarm of local residents: malaria-carrying mosquitoes.

"They had a tough time," the Maryknoll missioner says of his predecessors to the Mara Region on the eastern shore of the lake. Malaria claimed the first missioners there, taking two priests at an early mission in 1911, as well as the first priest of Kowak where Conard is now pastor.

"That's why Kowak is up high—you're trying to get away from the mosquitoes and you can't," he says. "We're not high enough and we're near the lake."

To that end, the Maryknoll Sisters founded the Kowak health center in 1949. The center remains a frontline outpost in the battle against the disease, even as it increases its role in treating the other great plague of modern East Africa: AIDS.

"Ninety percent of the patients here are under 5 years old and most of them have malaria," says Thomas Scott, a Maryknoll lay missioner who works with Conard. "You have to give them a blood transfusion." Conard notes the health center performs 150 to 200 blood transfusions a month, mostly to treat malaria in young children.

Conard calls the health center a "referral hospital" because residents of area villages and bush try folk remedies first and only come to Kowak when those fail. The nearest official hospital is 45 minutes away, the priest says. The health center currently has no staff physician, but has two nurses, who are Sisters of the Adoration of the Blessed Sacrament from India.

The center tests for the AIDS-causing HIV virus and will soon dispense life-saving antiretroviral medication, says Sister Grace Maria, one of the nurses. The center is starting a tuberculosis clinic and a clinic for malnourished children, Conard says.

The center is not self-sustaining and relies on funding from outside donors, especially from Kowak's sister parish, Our Lady of Lourdes Parish in Brighton, N.Y., near Rochester.

"I would have to close the hospital without their help," Conard says.

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Maryknollers in Musoma, Tanzania