Background: Ray Martin’s diverse career has throughout reflected the values he derived from his Mennonite upbringing and it has taken him over the decades to many countries, development institutions, and sectors. In this conversation with Katherine Marshall, he reflected on different phases and turning points in his long career. Among many points he highlights are how much he learned from each position he held, his mentoring roles, and the challenges the world and development professionals face today. The discussion spans many topics including public health, family planning and population, and climate change, as well as the joys and challenges of a public service career focused on international development.

So where did you come from and how did you get started? That's the beginning. Let's begin at the beginning.

I have to go back to my birth origins and the place and the culture where I was introduced to life on Earth. That was a fairly conservative rural Mennonite community in Lancaster County, Pennsylvania, growing up on a farm surrounded by other farms, most of which were owned and farmed by Mennonites or Amish. Even the elementary school that I attended was a one-room, red brick schoolhouse with one teacher teaching eight grades: all subjects for eight grades. And naturally, that culture, which was very much centered around our church and family, was not very global in its perspectives.

There was one exception: people interested in missions, carrying the gospel to far flung climes, to bring what they perceived as the truth, the word of God, to all these folks in Africa and elsewhere. That missionary vision was like a window into a larger world. Other than that, it was very inward looking, making a living on a farm, raising steers and, I have to regret to say, raising tobacco, to make a living in a community where so much revolved around the church.

I went to college eventually. I almost didn't even go to high school, because there was a strong feeling among many people, which is still the case with very conservative Mennonites and Amish, that all the education you need is eight years. Reading and writing and arithmetic: of course, that's all you need in order to survive in the world. And there is probably some concern that a lot of education might lead you away from God and the community.

My father ultimately did allow me to go to high school, and then I went to college and to Africa for three years as alternative service to military service, since Mennonites were pacifists.

So why did you go to Africa?

The draft was still in place at that time. So as conscientious objectors, we had to do something, some alternative service. For me, I had a sense of adventure, I guess, and influenced somewhat by my father's interest in international missions, I wanted to go overseas. So I went under a church program to Somalia and then Tanzania, when it was still Tanganyika, living in Dar Salaam, working at the Christian Council of Tanganyika. At that time, this was 1963, '64, before many of the Southern African countries had become independent. These independence movements all had offices in Dar Salaam, the capital of Tanzania, which had not long previous become independent from Britain.

Thus I was working in that very exciting setting of the independence movements for Southern African countries. I got to meet people like Eduardo Mondlane, who is sometimes thought of as the father of Mozambique, and other distinguished people involved in the early independence movements of their countries. It was a life-changing transition for me from a fairly narrow church focused life as a boy and a young man toward progressively opening up to a much larger world that then ultimately led to my choosing to work for USAID.

Where did you go to college?

I started, because of my strong Mennonite cultural background, at Eastern Mennonite, which is in Harrisonburg, Virginia. After two years, I went to Africa. When I came back, I didn't want to go back to a Mennonite college, so I went to UCLA for one semester. That, however, was not a good place to readjust, as I had become a rather different person in many ways. I ended up graduating from another Mennonite College, Goshen College in Goshen, Indiana, and then graduate school at Vanderbilt, in economics. I also mid-career studied public health at Johns Hopkins in Baltimore and earned an MPH.

So an eclectic education!

I skipped around! It's not something that I would recommend routinely to young people that I mentor, but it worked out for me.

You said these experiences took you eventually to USAID. What was the route?

After my three years in Africa under the church, in a Mennonite managed program, and then a couple more years of college, I wanted to work internationally. I had clearly been enticed to a career working in international development. I was struggling with the decision about whether I would go the route that most other people in my cultural setting would go to, which would be to work for the Mennonite Central Committee, MCC, wherever I was sent. But in my alternative service in Somalia, we had some interaction with the USAID folks in Somalia. That was where I discovered the U.S. Agency for International Development. And then in Dar Salaam, Tanzania, the Christian Council of Tanganyika office was actually in the same building that the USAID office to Tanzania was in. I saw USAID in action. And so a second option other than going to work internationally through the church was to consider something like USAID.

At that time, Mennonites did not generally work for the government. There was enough distance, and I wouldn't say hostility, but some suspicion of getting too close, too involved with government. But I decided that I would be sort of a pathfinder. I think to some degree it reflected my love for adventure, trying something new, something a little out of the ordinary for my culture. I chose to work for USAID. 

USAID was hiring fairly liberally then. Because of my background in economics, plus the fact that I had already served three years in Africa (although it was under the church, it was something of a Peace Corps kind of setting,) I was deemed a good bet for USAID.

I joined USAID in 1967 as a foreign service officer, with the attitude that if working for USAID made demands on me that violated my values, or made me uncomfortable working in a government environment, I could quit. It wasn't making a lifetime commitment. I ended up working 25 years for USAID.

And what was your path in USAID, roughly?

I started out as a junior officer in the Africa Bureau. The junior officer program then typically involved spending a half year in Washington for orientation, moving around to a couple different offices to get experience about how USAID Washington works, then assigned to your first foreign aid post. There were six junior officers for the Africa Bureau. Since I spoke some French already, I was selected for Morocco. After the Washington orientation, I went to Morocco as a junior officer and worked in a couple of the different divisions of the mission in Rabat, again, to get a broad experience with how USAID works and how a mission is organized. That was oriented toward becoming a program officer. A program officer coordinates all the divisions: health, education, agriculture, food. After a couple years of experience and promotions, I became an assistant program officer. I spent two years in Morocco.

As you look back on the first assignment in Morocco, was there any religious dimension to it? I mean, in your perspective and your understanding of what you were doing in Morocco.

Only in an indirect way. In the late ‘60s, early ‘70s, a Mennonite working for the government was very unusual. What I was doing was unconventional in that I opted to work for the US government. Most Mennonites, most people in my community, relatives, people from the church, other Mennonite leaders, did not see what I was doing as too much out of the ordinary, because Mennonites themselves had mission programs that involved education and agriculture and health. I could present what I was doing through a government agency as very similar to what the church was doing in its various mission outreach programs. USAID’s programs were fairly compatible with my goals and values.

You didn't see any incompatibility?

No. To be sure, my relationship with my early culture in the church was evolving; it definitely did not stay the same. But I was comfortable seeing what I was doing and what USAID was seeking to do in its development programs as compatible with values and history and experience I had had through church programs.

You came back to Washington during the Vietnam War. Then what happened?

The next phase of my career was rather tumultuous. At that time, USAID was in Vietnam in a very big way. That was the time when President Lyndon Johnson and the US government decided that if the South Vietnamese could not defeat what we thought of as the Vietnamese Communists, the Viet Cong and the North Vietnamese, by golly, we were going to do it. Thinking of it now, that period and our policy just leaves me aghast. We had over half a million American soldiers in Vietnam, that little country. And part of the strategy involved a major role for USAID in trying to do what we called winning “the hearts and minds” of the people. The idea was that there had to be a major military push to defeat the Viet Cong and the North Vietnamese, but we also had to win the support of the South Vietnamese population. The strategy for doing that was all kinds of development programs, that involved an all-of-government strategy, including USAID.

There was such a huge demand for USAID positions in Vietnam and many USAID people were being channeled to Vietnam. I was assigned to Vietnam to a program that was a collaboration between USAID, the State Department, the Department of Agriculture, the US Army, and the CIA. Even though I was no longer completely adherent to all the religious beliefs and doctrines that I grew up with, I'd had a strong pacifist background as a Mennonite, and I could not in good conscience work in a program that was a collaboration involving the US Army, the CIA. So I refused to accept that assignment. I had a standoff with my agency because I refused to accept that assignment. In the foreign service, if you refuse an official assignment, you can be fired. For a period of several months, I wasn't sure whether I would survive in USAID. In the end, they decided that it wouldn't accomplish anything for USAID to fire me. I got an assignment in Washington as a program officer in the Africa Bureau. But my first period included some rocky times.

The next chapter?

I was in the development planning office for a couple of years, managing a self-help program and assisting in the overall Africa Bureau program management. I was then transferred to a development coordinating and planning office for another bureau, Population and Humanitarian Assistance. Gerald Keefer was the assistant administrator. I was still doing program coordination this time for the program that included the USAID population program and some other social welfare kinds of activities. During that period, I became so interested in the USAID population and family planning program that I became increasingly interested in the technical dimensions and project management in USAID’s population and family planning field.

At that time, USAID, and the US Congress, were very strongly of the opinion that one of the biggest challenges to improving the lives of people in poor countries was overpopulation, or at least too high population growth rates. That was not a view that was universally held, but in USAID it was strongly held, and there were some very powerful US Congress people who felt that way also, and gave strong support to rapidly building up funding and assistance. The USAID population program started in the late 1960s, and it built up very fast. At the very beginning, a lot of the communications about USAID support for family planning andreproductive health programs, were so sensitive politically that very routine communications were sent classified, LOU: limited official use. The concern was that if some Americans knew that we were doing this, opposition would build up. But the leaders of USAID and many powerful people in Congress were absolutely convinced that making this effort to help countries reduce their population growth rates was essential to development and improving the wellbeing of the population.

USAID’s population program was an unconventional new kind of challenge, the adventure a person like me looks for, something on the cutting edge. It was appealing to me. After working in the program coordination office for all these programs, I transferred into a position in the population office where we were supporting country programs that were aimed at promoting family planning, encouraging people to have fewer children or to space their children. Kenya’s annual population growth rate was then about 4%, the highest in the world at that time. A 4% growth rate means that the population doubles about every 17 years or so. Even if you favor a population increase, with a population that's growing that fast, you just can't keep up, for education, food security, and other areas. There was a lot of controversy about the best strategy to reduce population growth rates, and the World Bank wasn't quite as convinced as USAID was that the best answer was promoting family planning and reproductive health, including contraceptive services programs.

The head of the population office for many years was a dynamic, charismatic epidemiologist, Rei Ravenholt. He thought we simply had to distribute pills and condoms, and people would use them and have fewer children. Well, it wasn't quite that simple, though that was an important ingredient of success. Looking back now, many experts, including some early doubters, would see the efforts as a fairly spectacular success. In Africa, population is still growing rapidly, but in most of the rest of the world, it's not growing so much anymore. In China it's actually decreasing, though USAID had nothing to do with that.

I got involved, at the Washington level, in population and family planning programs. In 1978, I was assigned overseas to the USAID mission in Ghana, West Africa, as a population officer. Thus from coordinating programs at the central level in Washington, I was then coordinating and managing programs at the country level, and feeling quite good about it.

Most of the rest of my USAID career was overseas. From Ghana, I was transferred to Cameroon, where I was doing much the same kind of thing. With some promotions, I eventually became the director of the overall health, population, and nutrition division, with quite a bit of emphasis on family planning, but doing primary health care and other kinds of projects. In my own career growth, that was a step up, because as a division chief I was part of the overall management of the mission, going to the senior staff meetings and so forth. The four years in Cameroon were good years for me. My son was born in Cameroon, my daughter when we were posted in Ghana. Being a family man overseas was great. And interestingly, my daughter and son-in-law are finding that too. In many ways, it's just easier raising children to be overseas.

I went from Ghana to Cameroon, and after four years there, I had the good fortune to win a USAID scholarship, a one-year long-term training opportunity. That's when I got my master's degree in public health. I had studied economics before and now I got a master's degree in public health, at taxpayer expense, at Johns Hopkins School of Public Health in Baltimore.

I went from there to Pakistan as the chief of the health, population, nutrition office in Islamabad, the capital of Pakistan. I had four good years in Pakistan, which was going through some tumultuous periods. When we were there, the head of state, Muhammad Zia-ul-Haq, was assassinated, bombed out of the sky in an airplane along with the American ambassador. Serving overseas is not always exactly safe. There were some major government changes. Even now, Pakistan is going through a lot of turmoil. It was very exciting to be working in that very large Muslim country, managing a very large portfolio of projects, totaling about a quarter of a billion dollars of health projects in family planning/population, malaria control, primary health care, and some water activities. From a career standpoint, being responsible for a very large program with a lot of money and a fairly large staff was very satisfying.

Let's continue the journey. After Pakistan?

We served in Pakistan from 1985, for two tours of two years each, until 1989. I then went to what was then called Zaire, now the Democratic Republic of Congo, where I lived in Kinshasa and traveled around the country. That was then the biggest health program in the Africa Bureau of USAID, not as big as the Pakistan program, but still a substantial program, supporting family planning projects, reproductive health projects, contraceptive distribution and primary health care. Malaria was also a challenge. And then in the late eighties, the new challenge of HIV/AIDS: the whole global AIDS pandemic started in that area of the world, central Africa. There were some early efforts to understand this new, mysterious disease and some of the field work was done in Zaire or Congo.

Did you get involved at all with the 1985 Cairo Conference on population and controversies surrounding it

Not directly. Some colleagues went to it, but I was not involved. There were, though, some pretty strong arguments in favor of the view that the population growth problem would sort of automatically be solved with general development. But the USAID approach, initially pioneered by Rei Ravenholt, with some strong support from people like Hubert Humphrey in Congress, didn't argue against the value of overall development as a positive thing, but they did argue that it would work more effectively if you had very direct programs promoting contraceptive use and practice. The conviction was that a lot of families, couples, women, wanted to have children, but the reason that they were having as many children as they were is that they didn't have any easy way to be a wife and not to keep having more children. Accordingly, a very important strategy from that point of view was to provide the means and the commodities to enable couples to have only the number and spacing of children that they desired and not more. And at the Cairo Conference, not everybody took that view.

Where did you go from Zaire?

We had completed a two year tour in Zaire, and had just started a second two-year tour when things in Zaire started getting very, very confused and problematic. The president for a long time was Mobutu Sese Seko, who is now seen as one of the most selfish and corrupt African leaders, who worked for himself and not so much for improving the lives of everybody in the country. Conditions were getting worse. Just surviving was getting to be a challenge, and people were increasingly disaffected by his leadership. That led to a major bout of looting in Kinshasa in September of 1991. There was a major challenge to Mobutu Sese Seko and his leadership, and the country didn't recover from that for a long time. Mobutu, before too long, was actually kicked out of the country; he went to Morocco, and soon died. There was a lot of chaos and uncertainty. Continuing with a development program under those conditions just didn't work. Most of the aid missions, including USAID, pulled out of the country in 1991-92.

I came back to Washington, closed up a lot of the projects and the contracts that we had had in Zaire. And then I had the good fortune of being offered a Public Health Specialist position at the World Bank in 1992. I was eligible for retirement from USAID, so it wasn't difficult for me to leave USAID and take this assignment in the Africa region, AF3PH, with Jacques Baudouy and others in one of then six divisions of the Africa region of the World Bank, the division that was managing Bank-funded projects in French speaking countries. I spoke pretty decent French then, and they needed another project manager.

I worked at the World Bank full-time for a while, and then cut it back to part-time, going on missions, I continued to work in Congo, still called Zaire, because I'd had all that experience, and did some management of Bank financed programs in Madagascar, Rwanda and Burundi. That was a very, very satisfying period of my career, where I could work with an international staff. That was one of the delights, because in USAID, you're surrounded by other Americans and the people in whatever country you're in, but it's not a more eclectic international staff. So that character of the World Bank with colleagues from many different countries was very exciting. I was managing health related projects and got involved some in AIDS also, because by the 1990s, the AIDS epidemic was expanding in territory and in prevalence in many African countries. Scary percentages of adults were becoming HIV positive. I was involved some in the Bank's early efforts to address this new and growing challenge of HIV and AIDS.

That was sort of a capstone of my career working with large, well-funded international development programs. Although the World Bank does not fund religious activities, I was one of the few Bank health specialists who realized that religious and faith-inspired organizations played a huge role in health programs in Sub-Saharan Africa. As a consequence, I deliberately sought ways to tap this potential by collaborating with faith-based organizations, an opportunity that was overlooked by many of my colleagues. I am sure that my appreciation of this reality was a result of my own strong religious background.

That led into working for a nonprofit where we didn't have so much money, but we could still make a difference.

How did you make that transition? Were you part of creating CCIH?

We're talking about an organization that's still very much in existence and thriving: Christian Connections for International Health. A lot of people think that I founded it because until I became the executive director in 2000, it was a fairly small organization. During my 14 years as executive director, it grew a lot and became much better known, with a lot more members. It is a membership organization, a large network. So people associate the organization with me. I helped make it what it is today, but I'm not the original founder. The website is simply CCIH.org.

The idea for Christian Connections for International Health is that there are many different faith-based organizations, Christian or otherwise, that are involved in health programs in developing countries. And it would make sense for there to be some level of interaction among these different organizations and for their leaders to compare notes, learn from one another, coordinate programs, and sometimes actually form partnerships to do more together than any one organization could do by itself. People saw the value of having a coordinating network, which is what CCIH was. We had, after a while, 130 organizations that were members, plus several hundred individuals, as individuals could also join.

I was thus able to conclude an important part of my public health career in an environment, a setting that was ideal in a number of ways, because I had this USAID and World Bank experience. One thing that I was interested in and members were interested in too, was building closer collaboration between faith-based or Christian organizations and their programs and the programs of big country donor organizations like USAID or international institutions like the World Bank. I was well-placed to provide leadership of that kind.

For me personally, having had this quite religious background growing up, even though I changed a lot, I still felt the importance of people of faith, people motivated in their programs and their actions, at least in part by their faith and values. I was very comfortable in that kind of environment. It was a very logical follow on to my service at USAID and the World Bank. And it gave me great pleasure to be at the center of a coordinating mechanism involving so many different church organizations involved in health and various other non-governmental agencies working in the health sector in Africa and Latin America, and Asia. We were deeply involved in Africa. CCIH started out as a network of American organizations involved in global health, but during my time, we put a lot of emphasis not only on being a coordinating network of American organizations, but making it a truly global network of faith-inspired organizations involved in health. In many African countries, there are in-country networks, faith-based networks or various NGOs, country NGOs involved in health. Many of them wanted to join our network too, to be connected not just with other programs in their country, but in a more global sense for sharing and learning and fundraising too. Having such a network enabled us to successfully compete for funding to implement projects. In my early days, our annual budget might have been something like $20,000. We were basically operating with volunteers. Now CCIH’s annual budget is nearly two million dollars, which is not a lot of money for projects, but for just the coordination function, it is a fair amount. If you're talking about implementing programs, it's not a lot of money, but I think the value of CCIH is not so much what it does through its programs, but what it can support and enable through the coordinating and supporting coordinating mechanisms, fostering the building of partnerships among various members.

The name is Christian Connections, so it's that connecting function, which is what makes CCIH as valuable as it is.

As you look back at the CCIH period, the 14 years you say, which you took from a very small organization to something much more ambitious and with a wider spread, what were some of the topics that, as we say, kept you awake at night or that were the substantive focus, apart from fundraising and just generally building a network?

The fundraising is relevant, because there was a lot of demand for the kind of education, connecting, networking that we could do but we did not have many resources. Most donor organizations don't want to fund that kind of thing. So that is a pretty important focus. Some of the controversial areas were, one actually was in the area of family planning.

I had mentioned earlier that in USAID and to some extent in my time at the World Bank too, I was very involved in programs aimed at helping countries reduce high rates of population growth, following a strategy of distribution of contraceptives, and encouraging individuals or couples to practice contraception. At the beginning, CCIH was not involved in that at all, but I was convinced that even in a faith-inspired organization or a faith setting, reproductive health should be a very central component of overall health services. So the question was: could we, could I, get CCIH, to agree on the importance of family planning, given some of the controversies and sensitivities. Family planning and contraception have to do with sex. Many organizations found that it was just easier not to get involved. But I thought it was important to get involved in this area because it was very important for public health, for family health. Dr. Douglas Huber, who felt the same way, and I conspired to try over a couple year period to get the CCIH membership and its board to be comfortable working explicitly in the area of population and family planning. We had a couple of discussions at our annual conference, and the sky did not fall. We worked bit by bit with organizations that were open to working in this area, supporting them and publicizing what they were doing. And it worked.

We had to be very clear that our definition of family planning did not include abortion, even though some of our members were okay with abortion. We're a network of over a hundred different organizations. Some are very liberal, some are very conservative. One of the challenges was getting the thread through the needle, staying right in the center in order not to drive away people on the right or drive away people on the left. And in the area of family planning, that was a bit of a challenge. I was disappointed, although not super surprised, that one of the members that we lost by getting involved in this area was Catholic Relief Services. It's not because a lot of the Catholic Relief Services staff or service providers are not interested in reproductive health and family planning, but the Church hierarchy has its rules. And when it comes to a decision about who you pay dues to to be a member, that kind of matter looms large. I said once to the head of Catholic Relief Services that we were strong proponents of what's often called natural family planning, which the Catholic Church is okay with. And he understood that we were supporting methods that the Catholic Church supported, but we were also promoting methods that most Catholic individuals are okay with, but the Catholic hierarchy is not okay with. They saw a major risk to their fundraising if they got too closely allied with organizations that were publicly promoting contraceptive services. I understood that, but I regretted that was the case.

Another struggle was that, over time, more and more people saw the value of a network like ours, including organizations that were not faith-based or faith inspired; they were not Christian, but wanted to benefit from the coordinating and educational and promotional kinds of activities that CCIH was carrying out. With the organization’s name “Christian Connections for International Health”, what were we to do about secular organizations that see the value of being allied with a network of Christian organizations? How to respond to these secular organizations? The board struggled with that. It took us three years to figure out what to do. We decided one thing at one board meeting, then the opposite at the next. At one point we called these organizations Friends of CCIH, not members, but Friends of CCIH. What we eventually hit on, and what's still the case, is that such organizations are called affiliates. They are not technically members of the network, but the network is very happy to work with organizations like these. And because they're not members, we charge them higher dues than the Christian organizations.

In your post organizational career, the environment is a central interest. How did that come about and what is your focus now?

One implication of my faith background with a strong orientation toward service is a commitment to building a better world and leaving a healthy planet for future generations. We know now the long-term risks that we're taking with our unsustainable economy, our unsustainable lifestyles, resulting in climate change, and the impact that climate change is already having on lives of people around the world. And the hardships will only grow over time. I don't see that too closely related to my work in public health, although I can make some linkages. When I finally retired from CCIH in 2014, I was 74. I guess I'm just not the type of person who's going to sit around and watch basketball games or soap operas or whatever. I was pretty convinced by then because it was becoming increasingly obvious that the changing climate was going to change the realities of the world in very major ways, that the biggest challenge many people, including myself, would actually face--call it an existential issue--was climate change.

I grew up on a farm and loved it. In school I had a leaf collection. Every year my brothers and I would compete to see how many species of birds we could identify. I built my own telescope, ground the mirror for a reflecting telescope, in high school, and got first prize in the county science fair. This interest in science was very much a part of my life from boyhood. Living on a farm, we were very close to nature. We grew things. That's how we made a living, by growing things. That respect for nature was an important part, an underlying dimension of my identity, even before a career with USAID, World Bank, and CCIH.

I felt that it was my generation and previous generations too, but particularly my generation, that made risky choices in our economy, in our public policies relating to use of natural resources, relating to pollution. We made choices that were not sustainable in the long run. We may have felt, we did feel, that in the short run, we would basically make money while creating problems for people in the future. Maybe we didn't admit that, but that was basically what we were doing. My whole life is devoted to trying to build a better world, and building a better world isn't just for me: it's for my kids and grandkids and everybody else's children and grandchildren.

Consequently, I decided that to the extent I'll stay involved in the public sphere during my retirement, volunteering, being active to some degree in the political arena, educating and promoting policies that are more sustainable, that would be the focus of most of my post-retirement time and energy. I saved a lot of money in my career at USAID and the World Bank. I was paid well. I lived comfortably, but modestly so we saved a lot of money. I had the misfortune of losing my wife to cancer in 2015. And so here I am retired, with substantial savings and time to do whatever I choose to do. I decided that my main focus, and continuing now in 2023, would be on environment, climate change, and environmental justice, and that I would devote significant time, including some of my money, to support efforts to address these problems, to try to get our society and economy back on a more sustainable path.

What is the focus of what you're doing?

I lived in McLean, Virginia, for 29 years. A year and a half ago, I moved to Greenspring, a retirement community in southern Fairfax County, Virginia. At this late stage in my life, after five decades devoted to international affairs, I am getting involved in local issues. I'm very involved in a Fairfax County, Virginia program called the Faith Alliance for Climate Solutions. I interact some with people from the Sierra Club, Third Act,a lot of organizations. I funded a major initiative in the Mennonite Church to try to get many Mennonite institutions more focused and directed in their programs toward trying to make a difference on climate change. So that's where I am. That's where my life is now.

How do you see the faith motivations in what you have done and are doing now?

Looking back at my entire life, an area where I'd struggled, particularly in my twenties, was how do I respond to a rather narrow perspective of what's the truth of faith experience: religious experience or engagement with a particular denomination that I grew up with. How do I respond to that as I enlarged my experience working globally, meeting people from many other religions and points of view. At first, it wasn't easy to have all the assumptions, doctrines, religious practices and truths that I learned in Sunday school and heard preached in sermons at church challenged, questioning whether everything that I thought was the truth, the one and only truth, really was the one and only truth.

It was actually a lifetime project of learning and adjusting my views and perceptions about things like this. I would say that my twenties were the most challenging time for me in that regard. But this continuous reevaluating and revising remained a process throughout my life. Even now, it continues, although it's not as painful as it was earlier in my life.

All of us should be seekers for our entire lives. We never finally arrive. Right now, I'm in a stage where in this retirement community where I live, I've found other people in similar situations. We're together seeking to deepen our spirituality in ways that are compatible with our backgrounds, but consistent with everything that we've learned in a lifetime of learning. We can make our advanced years a period of joy and being useful to society. Even at this late stage of life, I find being alive is very exciting: always questioning and refining my beliefs, learning how to become what I want to be.

It is, perhaps, centrally about integrity.

As you look back, what were highlights of those assignments?

I mentor young people sometimes, and I'm a big fan of encouraging young people to consider international careers in development if they have any interest at all. There are many opportunities. It's not always easy nowadays to get jobs. It was easier in my time than it is now, but the opportunities are there and there is satisfaction, much gratification in being a player in programs that change the world. We talk about making the world a better place. That sounds idealistic and some people may feel a bit cynical about such objectives.

One example that gives me great satisfaction. In 1990, there were about 10 million babies and children under five that died every year. 25 years later, that number was cut in half, even with population growth. The number of babies and young children who died, no chance to grow up, with parents grieving the loss of their children, is now under 5 million. There are many reasons. One is the much wider use of vaccinations against childhood diseases. Another is learning a lot and teaching people about good nutrition. Some of those deaths were because parents didn't know good ways of feeding their children and keeping them alive. Diarrhea was a very big cause of many, many deaths. We didn't exactly eliminate diarrhea, but we radically reduced the number of deaths caused by diarrhea. These are some of what we might think of as fairly elementary, not too expensive strategies for helping children survive and thrive. The chances now of a child growing up to be a productive member of society are much greater than they were 30 years ago. And even though I can't point to one particular child or this young person and say that I saved his life or her life--if you're a doctor, sometimes you can link your lifesaving effort to an individual--in the field of public health, it doesn't work that way, but I still have the satisfaction of knowing that I was part of an enterprise and approach, a commitment to building a better world that has saved millions of lives.

Another change over the last few decades is a greater degree of collaboration and partnerships between faith-based organizations involved in international development and governments and international development institutions. There is greater appreciation of the potential of civil society, including faith-inspired organizations. As executive director of Christian Connections for International Health, it was a privilege to contribute to this evolution

In my older age, I'm 83 now, thinking back on how I spent my life, these developments give me huge satisfaction.