On 8 June 1875, MacKenzie was welcomed to Hankou by Mr. and Mrs. Griffith John as well as Mr. Foster, his future colleagues. Hankou, previously known as the "Heart of the Empire", is large and situated in the middle of the central province of Hubei where the Yangtze River and the Han River meet. In Hankou, MacKenzie assisted Dr. Reid at the local missionary hospital and dispensary. In addition, MacKenzie also took daily Chinese lessons after work in the hospital. He faced tremendous prejudice because many of the Chinese did not trust the medicine of the foreign part of the Christians living in Hankou. But after MacKenzie successfully attended the chief deacon of the Hankou Church, the distrust was alleviated. In August, MacKenzie suffered heavily from malaria, but recovered in a month and he soon became head doctor at the hospital. Although he was very busy in the hospital, MacKenzie felt the urge to help the surrounding villages in the country-side surrounding Hankou. He and Mr. Joh, a colleague, visited a number of villages where eye disease was the most prevalent cases. At some of the villages they met physical hostility toward foreign Christians, but after meeting with the chief magistrate of the district, the magistrate issued a proclamation through the district and the villagers were much more welcoming the second time around.
