With some like-minded friends, he was instrumental in the founding of the Friends of the Sick Association (Fosa). Care committees were formed in all areas in then Natal where Indians were settled. The committees were responsible for locating TB patients and for looking after their welfare and that of their families, while they were receiving medical attention.

Pat Poovalingam, attorney (and later POST columnist) was the first Fosa secretary and later became chairman. Phyllis Naidoo, Lutchmanna Naidoo, Nadas and his wife Athie Pillay, Koosiram Badal, Ghunshiam Harkoo, RD Naidu, Kenneth Nair, Sivaramen Moodley, R Brijrajh, Mannie Naidoo, HS Singh, Dhama Nair, Nadarajan Moodley, Pydiah Naidoo, Vadi Runga, and many others, gave distinguished service.

Disability grants were applied for on behalf of the patients and financial assistance was provided until the grants were received. Despite the work of care committees, it soon became apparent that unless patients could be removed from their unhealthy environment, the disease would continue to spread.

Sykes decided to open a TB settlement. He wanted to treat the TB patient within his/her family group and not remove him/her from the nuclear family. The family must be involved in the treatment. They would be housed in cottages on the settlement and would be trained in the care of the patient. He also wanted to remove the financial worries from the sufferer, so that recovery could be unimpeded and once the patient was on the way to recovery, he/she could continue to live in the cottage.

A property, consisting of 25 acres (10 ha) owned by the Paruk and Lockhat families was secured in Newlands in 1944. Sykes resigned from his research post to concentrate on Fosa, moved out to the site and began putting up the first buildings. Fund-raising continued and slowly the settlement took shape. Volunteer nurses were engaged. The project included a children's hospital, cottages for the families of TB patients, a school for their children, vegetable gardens, a poultry section and a weaving school to help in the rehabilitation of convalescent patients.

There are many people today who will be able to fondly recall their connection to the Fosa settlement at Newlands, either living in one of the cottages or visiting relatives and friends there. The Newlands Settlement helped save many lives being lost to TB. Sykes set up other similar TB settlements around the country. The Newlands Settlement was by now run largely by members of the Indian community. This allowed Sykes to fulfil a lifelong dream to pursue religious work.

He joined the ministry because he admired the strong stand taken by the Anglican Church in speaking out against what they believed to be unjust. Throughout his stay in Durban, Sykes was an admirer of the Indian people, noting that “there runs throughout this outward evidence of poverty and sordidness, a silver thread of striving for the higher things, of a determination through hard work and application to improve standards, if not for the older ones but for the young so that they may have a fuller inheritance than was ever realisable for themselves”.

At the age of 80, Paul Sykes suffered a stroke. He was admitted to the King George V Hospital (now King Dinuzulu Hospital) where he died peacefully on May 7, 1983. His ashes were interred beside the original cottage at the Fosa Newlands Settlement.

Today the legacy of Paul Sykes lives on. Fosa continues working within communities, visiting the sick, and encouraging and aiding families in whatever way possible.The world is most certainly a poorer place today because we do not have enough people like Sykes. His ideals are best summed up in his own words: "Let us never be afraid to climb a little higher, to see a little further, to give of ourselves - our energy and our youth - so that we may put into practice the almost limitless project of care for our fellows.”

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The humanist who saved Indians perishing through TB