Spiritual Care for Foreigners

January-February 1999


Mr. Kendagor is a chaplain at St. Mary's Hospital and city director for International Students, Inc., St. Louis.

Immigrants Have Special Needs for Support and Understanding

People from other countries come to the United States for a variety of reasons. Some come to pursue the American dream and are here to take advantage of the educational and economic opportunities available in this country. They want to better their standard of living, and work hard to ensure a comfortable life for their families. Others are here because they are fleeing persecution, war, or other hardships at home. Whatever the reasons, they are here in large numbers — and they pose a challenge for spiritual care providers. How can chaplains meet the special spiritual needs represented by the international community, which continues to grow every year?

The people who land in this country as foreigners have needs and feelings that are common to everyone. However, they also face challenges and problems unfamiliar to native-born Americans. It is important for spiritual caregivers to be aware of these special difficulties in immigrants' lives and the emotional and spiritual needs that accompany them.

Cultural Adjustment
The most common challenge anyone moving to a foreign country encounters is adjusting to a different culture. The long and difficult preparations for the trip to the United States — obtaining a passport or visa, and saving or borrowing sufficient funds — distract one from thinking about the challenges waiting at the destination. Then it is time to say good-bye to family, friends, and a familiar culture and environment. One is uprooted from what is normal and familiar and plunged into a culture that is strange and unfamiliar. Suddenly the newcomer has to relearn how to differentiate between appropriate and inappropriate behavior, the acceptable and unacceptable.

I came to America from Kenya, and in my native culture it is considered polite for a guest to refuse food the first time it is offered. This gives the host an opportunity to insist, proving that the food is really available and that he genuinely wants to serve the guest. My roommate invited me to spend Christmas with his family, who were very kind and treated me as a family member. They told me to help myself to food any time I felt hungry, but no one insisted that I eat. So the only time I ate was when the family sat down for supper. I simply did not feel I could help myself to food, even though I was told to.

This is one example of the cultural adjustments internationals encounter as they try to make a living in this country. Many times they are caught between conflicting cultural values. Cultural adjustment is more than accepting the foreign culture; it is learning how to interpret and communicate in the new culture as well. That makes the adjustment a complicated experience.

Lack of Family Support
Initially, an immigrant's transition may be eased by a welcoming host family or friends. But soon everyone gets busy, and then, for immigrants who have no family here, the loneliness hits. Most non-Western countries have extended family structures, and individuals deal with problems by talking to the family, not outsiders such as professional counselors, as is common in Western cultures. Therefore, when an international who lacks support structures here encounters difficult or lonely situations, he or she does not know where to turn, and this can lead to a serious crisis. "Paul" (the names throughout this article have been changed), who was from a wealthy and elite family, came to the United States to study at a university. For his first Christmas here he planned to entertain himself with music, drinks, and food. "The moment I started my record player, I found myself staring in the direction that I thought was home," Paul says. For the first time since he was a child, he cried. His loneliness was so severe that "if a Muslim had come to me that day I would have become a Muslim," he recalls.

Identity Crisis
Whether an immigrant or a refugee, the newly arrived individual must struggle with the issue of identity. The saying "You can take someone out of his culture but you cannot take his culture out of him" holds true. Culture identifies us as a people. Kenyans have a culture that identify them as Kenyans. Americans have a culture that identifies them as Americans. Immigrants may find themselves unwilling to give up their culture and yet, for some, there is no possibility of ever returning to their country of origin. They may also feel torn about becoming American citizens, because to do so means giving up their home country citizenship. Their experience may be even further complicated by attitudes people may have toward their home country. Negative attitudes add to adjustment problems for immigrants.

Political Crises at Home
When the Iranian hostages crisis occurred, in 1979 and 1980, for some Americans any Iranian became an enemy. During the crisis hostility toward Iran mounted, and I know of several instances in which Iranian students were forced to hide their identity in order to avoid hostility. Making their situation worse, the conditions in Iran meant that many of them lost their financial support. But who was there to listen, understand their plight, and treat them as valuable human beings?

The Gulf War was an extremely difficult time for Iraqis here, especially those who had families in Iraq. They suffered the pain of knowing that their families were experiencing hardships, and at the same time they could not talk freely about their problems to anyone for fear of retaliatory actions. Even today many Iraqis hide their identity to avoid possible harm.

"Sam" came from Ethiopia but his family lived in Kuwait. The Gulf War meant that his family had to hurriedly flee Kuwait. When I met Sam he was a student trying to keep up with a full course load while struggling with his fears for his family, whose whereabouts he did not know. He had no idea where to go for help. Like many internationals, he had come to this country looking for peace and happiness but found himself dealing with the most unexpected circumstances.

When a country is at war, many innocent people are victimized. It is important for spiritual caregivers to be aware of needs at such times and to be prepared to respond and effectively minister to them. As servants of God we are called to reach out to and to share God's love with all.

Family Crises
Death or serious illness at home can create a serious crisis for the sojourner who may not have the means to return and be with family during moments of grief or illness. "Jennifer," a bright young woman, came to the United States with her husband and children and was doing well when crisis after crisis hit. Her father died, her brother was dying, and another brother was in the hospital with the same disease. I ministered to Jennifer during that difficult time. Fortunately, she had links to International Students, Inc. (ISI), an organization that assists internationals in their adjustment. With my help, ISI and Jennifer's church organized a memorial service, and her friends came to support Jennifer and her family here. Without that support, her pain would have been unbearable.

It is my hope that spiritual caregivers will become more aware of the need for providing spiritual services to those who have come to America in pursuit of opportunities. Foreign employees and patients have needs that are unique and, in most cases, they do not know how to get help.

Spiritual care providers need to take the opportunity to get to know them individually. Caregivers should not expect foreigners to confide in them right away, but should begin by simply being a friend, interested in them and in their culture. Such a relationship will lead to ministry opportunities that may have a long-lasting, and possibly global, effect.


Copyright © 1999 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Spiritual Care for Foreigners

Copyright © 1999 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.