When he first came to the state of Tamil Nadu, Kugelberg settled in the city of Pattukottai to conduct field research about the prevalence of disease. Kugelberg focused his efforts on treating two conditions: cataracts and leprosy. He then traveled to the more populated city of Tirupattur to implement his research.[1] He founded the Swedish Mission Hospital in Tirupattur and was chief medical officer from 1909 to 1932.[2] Kugelberg introduced novel cataract surgeries and leprosy antibiotics to the population. There were significant improvements in patient outcomes.[3] In addition, Kugelberg gave particular care to the female workers and patients. As a result of his work, Kugelberg received approval from the dominion of Madras (Chennai, Tamil Nadu) to continue his practice in neighboring cities as well. So in 1926, Kugelberg opened the Moses Gnanaparanam Eye Hospital at Coimbatore.[1]
The growth of the Moses Gnanaparanam Hospital was fast and it achieved equal success to the hospital in Tirupattur. His Excellency George Stanley, the then Governor of Madras, appreciated the "noble deeds" and requested Kugelberg to continue such "worthy" services to impoverished, rural communities. The British-colonized government realized the dire necessity for healthcare and decided to sponsor Kugelberg's services indefinitely.
Kugelberg particularly began believing in the Bible's verses regarding the blind being healed by Jesus Christ. Convinced of the mission, he opened a school for the blind in Tirupattur in the year 1929. Kugelberg not only performed surgery but taught the patients braille, music theory, and musical instruments. The blind were also trained in dancing, basket making, and handicrafts, which were then exported for profit. Kugelberg valued such economic incentivisation and the lasting effects it would have for the sustainability of the people.[1]
Kugelberg came to serve the neighboring rural communities. It was his belief that Christian compassion and obedience would reduce symptoms of sickness. He preached the Gospel regularly when consulting patients and is recognized for converting many Hindus to Christianity. Part of his message was equality between the sexes. In this vein, he opened a Christian teaching hospital for nurses in Madurai, as a way of including more women in healthcare.[1]