Malappuram, an urban area, is the emotional and geographical centre of the Mappila Muslim community.  It is densely populated.  When Roland and Mary Helen Miller arrived in 1953, they were overwhelmed by the physical and spiritual needs of the community.  Mrs. Miller began a back-verandah treatment program to help some of the 100,000 people without a single physician to care for them.  In the course of time this became a maternity and child-welfare centre. 
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Its nursery school portion, led by Mrs. Miller and Mrs. D. Francis, was the first such institution in Malabar, and it became a model for government services as well as for the wider church. 
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The maternity care section became the current Christian Welfare Centre (CWC), which now deals with thousands of women annually who attend for deliveries.  The CWC has also conducted major programs for tuberculosis and leprosy treatment, now sharply reduced, as well as general medicine. 
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The evangelism program has produced noticeable results.  It is now led by Rev. I Titus, whose outreach activities are given supplemental assistance by the MMS.  The main congregation, St. John's Lutheran Church, has now become the first self-supporting congregation in the Malabar Mission Circle.  It has just completed a full renovation of its fine church building, paid for by local contributions. 
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The Friendship Centre is located in downhill Malappuram and serves the area as a literature and reading room outreach centre.