In March, 1885, Dr. Swain received a call to a native state to attend the wife of the Rajah, and after two weeks of successful treatment she was formally requested to remain as physician to the Rani and the ladies of the palace. After much thought and prayer it seemed to her that it was the Lord's will that she should remain and do what she could for him in this place where there were no Christian influences; so she consented to the proposal on condition that she and her companion be allowed to carry on the work as Christians should. To this the Rajah agreed, and Dr. Swain signed a contract to remain two years.

In the Blue Book, or Administration Report, of the Khetri State, 1886, the Rajah wrote: "I cannot look back with greater pleasure or satisfaction on anything I have done than on the facilities introduced by me for rendering medical aid to the female portion of my subjects. It is a patent fact that the Indian woman, secluded as she is within the four walls of the zenana, cannot fully benefit by any system of medicine; and it was not till the generous efforts of Lady Dufferin were turned in this direction that the wives and daughters of the richest and most enlightened Indians enjoyed a better position than the lowest and meanest of their fellows. It therefore gives me genuine pleasure to bring prominently to your notice the existence of a regular institution in this benighted portion of India, for the treatment of females of all classes. I have employed a very competent European lady doctor, Miss Swain, M.D., to attend on Her Highness, the Rani Sahiba, and, feeling it my duty to place her advice and assistance within the reach of all my subjects, have established a regular dispensary for women. It was opened June 1, 1885, at the expense of the state, and a room in the palace building appropriated to it until a more convenient and suitable one could be provided. An allowance of Rs.100 per mensem is fixed for medicines, and is found for the present to be sufficient. The average daily attendance at the dispensary is five."

Under Section 12, Schools, this report is given: -- "I am glad to say that the people of my state are beginning to evince greater interest in the education of their children than they have done before. The greatest desire of Her Highness, the Rani Sahiba, was that I should make suitable provision for the education of girls. I, accordingly, engaged a competent European lady, Miss P.E. Pannell, as mistress, and the Khetri Girls' School was opened by Her Highness in April, 1885, in the teeth of opposition from the orthodox portion of the community. As was expected, at first every effort to teach these girls was frowned upon and considered absurd by their relatives and friends. This feeling, however, gradually gave place to trust and confidence, and the school is now showing some return for all the time and patience spent upon it. The number of pupils on the roll is twenty, of which three have gone to their susval (husband's home) and three attend only occasionally. The average attendance of fourteen girls has, however, been regular. Great pains has been taken to teach truthfulness, honesty and love for one another. Instruction is also given in needlework of various kinds, and other things, the knowledge of which is necessary for good housekeeping. The improvement made by some of the girls in this direction may at once be noticed by a change in the manner of doing nicely the little things which go to make up their lives. The school owes its existence to the care of Her Highness, who is much interested in it."

In addition to her school, Miss Pannell was engaged to teach the Rani and some of the court ladies. Dr. Swain and Miss Pannell were the only Christians in the state, but their little Sunday service conducted for their servants gained attention, and others asked to be allowed to attend, some becoming so much interested that they procured Bibles and Testaments that they might read the "wonderful words" themselves. A supply of tracts and portions of Scripture was always on hand, to distribute whenever and wherever the ladies felt they would be appreciated.