Strained Relationships between Healthy Cross-Cultural Workers
and Those Who Struggle with Chronic Illness

“Hey! How are you?”

It was a generic question, so of course I did not answer that I was not feeling well. I certainly was not going to mention that my fifty-three symptoms were getting worse; it would probably sound like I was trying to get attention. After all, every cross-cultural worker there was dealing with a different culture and all the challenges that came with it. Some were probably struggling with the local food or the heat or other aspects of living in that third world country.

The difference was that they were all still functioning as cross-cultural workers should. Doing ministry. Keeping up with relationships. Informing prayer supporters back home.

I, however, could not keep up.

Sunday nights were the worst. I dreaded going to the weekly service. It was the one time all the western cross-cultural workers got together, and most looked forward to this special thing. Not I. After spending the week trying to minister to our people group, the idea of chatting and socializing was exhausting.

Then there was the dessert. It was an unwritten rule that every woman brought some sort of refreshment to the service for the fellowship afterward. Some of the women outdid themselves making incredible homemade creations that impressed us all.

I struggled every week as Sunday came near. If I showed up with a snack I had bought at the store, I would feel the censure. Some of it may have been in my head, but the looks and the small, casually-made comments made it feel like it was not. I was not measuring up. I was being lazy. I did not care about the body of believers.

It should not have been a big deal. After all, I did not go to the field to impress others. Nevertheless, it hurt. It hurt when I had to say no to women’s get-togethers, and I could tell some were seeing me as a snob. It hurt when a teammate mentioned our biblical responsibility to care for and minister to the believers. It hurt those times I would stay home, knowing (or perhaps imagining) that the others assumed I was using some unnamed, perhaps unreal, illness as an excuse to avoid them.

My family eventually had to leave the field due to my health—or rather, the lack of it. I cannot express how difficult that was for me, how much like a failure it felt. In time, I did get that elusive diagnosis. I was able to say that yes, I did have a legitimate illness and no, I was not making it all up, or just having a bad round of culture shock, or just being self-absorbed.

Several years have passed since those days. I now live with an incurable disease and will likely never get to go overseas again, even for a visit. In fact, when I asked the doctor about returning overseas, he not only said no, but he added that he was surprised I had not “kicked off” already!

Now that I have a “real” and “legitimate” disease, I think people would give plenty of room for me and my limitations, were I on the field again. I would be able to express my limitations with confidence and say more clearly why I was not able to do as much as the others. Unfortunately, though, many women who struggle with illness on the field are like I was, in that they do not have an official diagnosis—a name that makes their symptoms legitimate to the world. So they hide away, or try to keep up with the healthy, pushing through sickness and often making their own situation worse, feeling judged and misunderstood and very, very alone.

Well, now that I have gone through the depressing part, let’s get to the good news. It does not have to be this way! Over these past years, I have learned that it is possible for healthy cross-cultural workers and cross-cultural workers who struggle with chronic illness to care for each other and overcome misunderstandings.

To do so, each side must first try to see things from the other side’s perspective. So here goes:

For the healthy, please know that a cross-cultural worker with chronic illness probably wishes she could do as much as you do, and that she feels guilty that she is not pulling her weight. She likely avoids talking about how she is really doing because she does not want to sound like she is whining, blaming God, or trying to get attention. Yet she struggles, wishing there was someone she could really talk to who would not judge her or assume she was exaggerating. Deep down, she probably fears the worst—that this is all really in her head. Fear, shame, and guilt follow her around, because without an official diagnosis, she feels no one will really take her illness seriously, and thus she pulls farther and farther away from the rejection (whether real or imagined).

For the sick, it would be good to remember that cross-cultural workers who are healthy also have plenty of their own daily struggles. They are also dealing with culture shock and the added stress of life in a new culture. They are constantly assessing the situations around them, so it is natural to try to assess your situation, too. If they offer a solution, it is likely given in the hopes that something will help you, rather than a condemnation that you are not better yet. They want to be understood, accepted, and appreciated.

Understanding is important, but it is only half the battle. What can cross-cultural workers actually do to avoid the misunderstandings and rifts that arise between healthy and unhealthy  cross-cultural workers?

If you are healthy, this is how you can help those with chronic illness:

  1. Believe them. Often what ill people want most is just validation—someone to recognize that their struggles are real.
  2. Be an advocate. If a friend has health problems, find out what their limitations are, and be an advocate to others who might not know the whole situation and may make incorrect assumptions.
  3. Adapt to their limitations. Is there a responsibility from which they could be freed (like making dessert for Sunday service)? Is there a ministry that would accommodate their limitations (proofreading materials as opposed to traveling to remote villages)?
  4. Pray for them and with them.
  5. Be compassionate. A little sincere kindness goes a long way.

Now, to those who live with illness, this is what you can do:

  1. Be real. If I had just admitted what I was going through and been a little more transparent, it likely would have made things a lot easier.
  2. Be specific and give options. State what is going on as clearly as you can, such as, “I can only attend one event this week. Should I come to the event with nationals or the event with other  cross-cultural workers?”
  3. Be sincere. Defensiveness makes things worse. Instead, say something like, “I miss getting together with everyone and wish I could come to more things.” It may even be best to write a note and have another  cross-cultural workers take it to read to the group; this could explain your limitations while still connecting with them.
  4. Pray for them and with them. No matter how sick you are, you can have the ministry of prayer. I wish I had gotten past my feeling of being judged and instead focused on caring for the other women and wanting to know how I could pray for them. I kept pulling farther and farther back, and they responded the same way. Praying is a powerful connector.
  5. Be compassionate. Those of us who are ill sometimes forget that sickness is not the only kind of suffering. We are not the only ones who need an encouraging hug, a word of affirmation, or just someone asking, “How are you?” and genuinely wanting to know the answer.


Opportunities for misunderstandings and discord abound on the field. However, the very same principles of love and kindness and compassion that we know we should have toward the lost around us are also tools Jesus wants us to use with one another. In fact, Jesus said the world would know we were His disciples by our love for each other, not by our love for the lost (John 13:35). If we can learn to understand and care for one another, regardless of our abilities or limitations, we may find that that becomes our greatest testimony to the world.


@2013 Thrive.


Question to consider:  How has this article helped you gain understanding?