A few months ago I wrote a letter to the missions organization that I was with for just under 10 years, and overseas for just over 6. What you have below is a slightly modified and truncated version of the letter, with specific persons and details removed. I share this in the hopes that it can possibly help others, and foster discussion about some of the questions missions organizations should be asking, as well as to give background to upcoming posts about missions and missions organizations.

In 2008 I joined the organization, and left for the field, single, December 2010. Along the way I got married, and my British husband and I have been back in the US now for just over a year, having resigned from the organization in August 2017.

I am writing because, while our leaving the organization last year felt both amicable and like the Lord’s good leading at the time, in the months since, through reflection and wise counsel, we are now coming to realize the depth of the hurt we carry – I now suffer from a chronic sickness, with regular debilitating pain that has no conventional cure – as a result of our time on the field.

I am writing not to lay blame at the feet of the organization– every organization has cracks through which people fall, and we were two people who fell through some of those cracks. However, as survivors of that fall, I feel impressed to highlight where those cracks are – so that others who may be slipping through can be caught in time.

It helps to share some of the scope of our time in the field. It was a full and tumultuous 6 years. I was single when I went out to a closed country in North Africa. In my first 2 years I experienced robbery, a house fire, sexual assault, and was eventually detained, interrogated, and expelled, leaving many of my personal belongings that I’ve never been able to retrieve. Later that year I moved to South Sudan, met my now husband, and a few months later civil war broke out in our city. After 3 tense and terrifying days we got evacuated out. Eventually we went back, then we got married, then accepted an offer to move to Cairo to work with refugees. It seemed a perfect fit. We travelled constantly the first 9 months of our marriage – never sleeping in one bed for more than 9 nights at a time and changing beds something like 48 times while we tried to fulfill obligations and double our support. We landed in Egypt and I was immediately struck with serious and recurring health issues. We had difficult work we loved, people and coworkers we adored, but I continued to deteriorate and we had no choice but to apply for a green card for my husband and relocate to the US.

The green card process took 11 months. During this time my health continued to get worse, and our workloads grew and grew, adding to the exhaustion. We were exhausted every single day. We were tired in our bones, committed to our work, but not doing well. We faced intractable problems like combatting racism in our workplace, personal challenges with our apartment (including another robbery), and the weight of grief of the suicide of a dear friend back home.

All the while, we were watching each other deteriorate. It was scary and isolating. We did not have the emotional energy to keep asking for help, and no-one – our area leader, our team, our local churches in the UK or USA, or member care at headquarters – seemed to feel responsible for us.

During this time, we’d kind of given up asking for help – over the 2 years in Cairo, we had less than half a dozen team meetings with our appointed team. A month or so before we left, the new Area Leader invited us over for lunch – and asked us to take on some more work, which we politely declined. So, we put our heads down and focused what little energies we had on our refugee friends at work, on keeping each other buoyant, on trying to still find joy and peace.

We got my husband’s green card and, 11 days later, flew to the US, in February 2017, utterly broken, and very sick. We immediately flew down to organization headquarters for a debrief. This was good, important time for us. But we’d only just landed, were still spinning, and didn’t have the emotional or spiritual resources we needed – we were mercifully able to begin to identify the wounds we carried but had yet to acknowledge their depth or permanence.

There is more to the story of course – secondary trauma I experienced, people I loved and was forced to leave, dear friends who were tortured and imprisoned, the constant heartbreak (and joy) that comes with working with vulnerable populations like street kids and refugees, difficult living situations, seeing horrific things we cannot unsee, more robberies, more deep joys, more grief.

In the months since returning, through reflection and wise counsel, we are now coming to realize the depth of the hurt we carry – I now suffer from a chronic sickness, with regular debilitating pain that has no conventional cure – as a result of our time on the field.

We are in a situation now where years of trauma and extreme stress have led to massive hormonal imbalances in my body. The doctor I’m seeing has never seen hormone levels this low for someone my age. I now have endometriosis, an illness with no conventional cure, and PTSD, among other things. I am applying for jobs, but only part time ones because I still struggle with chronic fatigue, and I’m still in debilitating pain on a regular basis. We’ve spent thousands and thousands of dollars out of pocket trying to get answers, and now for treatment for issues that are generally believed to have no cure and can commonly to lead to infertility and other complications. It’s been incredibly frustrating and demoralizing. Even heart breaking at times.

At the prompting of a friend who also experienced war in South Sudan, I have started seeing a trauma therapist. I still have PTSD from my years overseas, hyper vigilance, and elevated stress levels because my brain and body have a very difficult time believing it is safe now.

Our experience and our trauma were not the fault of any one individual at your organization. However, every organization has cracks they can’t see, and we slipped through them and were hurt in the process. I can’t imagine that we are the only ones. I do not wish to lay blame at the feet of your organization, however, as survivors of that fall, I feel impressed to highlight where those cracks are – so that others who may be slipping through can be caught in time.

I also share these reflections with the large caveat that our situation was particularly complicated, and many of the decisions made were indeed the best possible decisions we – my husband and I together with the organization – could have made at the time. I also want to state my gratitude to you – you made it possible for my husband and I to serve together, and I was so well taken care of by my team and area leader in North Africa and South Sudan, and I have nothing but good things to say about those individuals.

  • Once we were in Egypt, however, it felt like no one in the organization felt responsible for us – not our team, not our AL, and not member care back in the US. When we faced our health, work, house challenges, we had nowhere to turn. If it hadn’t been for an expat counselor just happening to show up for a visit in Cairo when she did I don’t know what we would have done. 
  • Second, our supporting church was so only in name and finances – we did not have access to pastoral care or support outside of our organization. I know this isn’t the case for everyone – some people go to the field with rich pastoral resources from sending churches. However, this was not the case for us. This is something we raised throughout our time overseas, but I’m not sure it was ever factored into decisions from member care about our needs.
  • In going over in detail with my therapist about my 6 years overseas, she couldn’t believe no one told us to stop. Maybe when asked, we said we were fine – perhaps our newsletters were too positive. But we were so deep in just making it from one day to the next, though, we were not able to see our situation clearly.
  • This is why team and leadership are so important. We weren’t seen because of an institutional failure. We needed someone to see us – we needed our Team Leaders to see us and speak in. Our Team Leaders, though, were too burnt out to provide the support we needed – they needed an Area Leader to see them and speak in, too. The Area Leader, though, wasn’t able to support them, because he was wearing too many hats, was doing too much. This has been addressed, and now there is a different Area Leader set up for that region. But for us it was too late.

Again, we harbor no ill will towards these individuals. But there was a clear oversight – if our team leaders are too burned out to support us and tell us to stop, and their leader is too burnt out to support them and tell them to stop, of course there will be breakdowns. People will suffer. We did. We are.

  • Finally, nobody was able to identify effective remedies to our issues from a mental health perspective. I carry trauma in my body. My health might never recover as a result of years of stress hormones pumping through and altering my body and brain chemistry.

Throughout our time overseas, and even during debrief retreats at organization headquarters, however, the advice we received was to get plenty of rest. But rest alone could not possibly heal what the years overseas have done to my body. I needed professional trauma counseling. We were given recommendations for 3-week retreats requiring more travel that we were not up for nor could afford, but never recommended to seek out professional counseling where we were living, nor for any practical resources about how to process and deal with trauma. If I had received timely advice to seek professional mental health services, perhaps the health problems I have would be easier to reverse. Perhaps we could have even stayed on the field. Or at the very least I could be working again. That it took over a year of being back home for someone – a fellow Christian overseas worker – to recommend professional psychiatric help seems like a large oversight – or even a failure of duty of care.

These are some of the things the Lord has brought to light about our time overseas in the last year, where we feel the structure of support failed us. It may be that the issues I raised have already been addressed. If so, praise God! However, in all humility, I want share these things to highlight some of the causes of our painful return from the field, with the sincere hope that others can be spared our pain.

Many thanks for all you’ve done for me and for us over the years, and for your consideration of my words here. I look forward to reading your response in the near future.

All the best.

I’m very pleased to say that I didin fact, receive a response a few weeks ago. And I have feelings about it. In Part 2 I will share about their feedback, and my response to their reply.

Categories: Uncategorized


Pramila · February 8, 2019 at 2:03 pm

How can I get your all 4 ebooks on my Kindle.

Missions Organizations Have Cracks [Part 2] – My Response to Their Response – Beth Watkins · August 13, 2018 at 1:32 pm

[…] organization I was overseas with for more than 6 years. This letter, which you can read the gist of here, detailed what I felt were institutional failures that led to my being sick and burned out, and, […]

Missons Organizations Have Cracks [Part 4] – Do I Regret Going? – Beth Watkins · September 13, 2018 at 4:52 pm

[…] in the miniseries called “Missions Organizations Have Cracks.” For more context please see part 1 where I share a truncated version of a letter I wrote to my former missions organization detailing […]

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