Ruth Arnold Smarinsky, PharmD: A strong force for good

Not hurricanes. Not earthquakes. Nothing stops Smarinsky from speeding medicines to the world’s worst disaster areas.

Dr. Smarinsky. Illustration by John Jay Cabuay.

by George Spencer. Originally published in UCSF Magazine.

“See a need. Fill a need.” That’s the motto of Ruth Arnold Smarinsky. For the past 17 years, she has been a driving force at Direct Relief, ranked by Forbes as the nation’s third largest charity and the largest charitable provider of prescription drugs in the U.S. The Santa Barbara, Calif., nonprofit distributed more than $1.6 billion worth of medicine and supplies in 97 nations in fiscal year 2022 and sent $400 million in aid to Ukraine last year.

“When I see a problem, I’m untiring – like a bulldog sometimes, aggressive but not obnoxiously so. I don’t let obstacles stop me. I find a way to make things work,” says Smarinsky, who was named Pharmacist of the Year in 2022 by the California Pharmacists Association. “I couldn’t do any of this without teamwork,” she adds.

As Direct Relief’s longtime director of pharmacy and clinical affairs, she greatly expanded its U.S. operations while speeding its ability to respond to global crises. She oversaw the donation of millions of prescription medications, created standardized health kits for use during disasters, and forged partnerships with more than 2,000 nonprofit health centers in underserved areas.

Before she joined Direct Relief, she set up pharmacy services and clinical pharmacy systems for Venice Family Clinic, then the nation’s largest free clinic. “I like starting new, efficient programs to help people. I try to imagine each person on the other end who’s in a crisis. I want to make things easier for them,” says Smarinsky. While at Venice, she was also a volunteer UCSF faculty member and a preceptor for fourth-year pharmacy students.

A native of Antelope Valley, Calif., she was recently promoted to senior adviser at Direct Relief. In her new role, she’s tasked with envisioning future directions for the organization. She foresees bigger investments in mobile medical units and street medicine, to bring care to unsheltered people. She is allying with the European Renal Association and its Ukraine Task Force, believing that Direct Relief needs to do more after disasters to help nephrology patients and others with life-threatening diseases.

The challenges facing Direct Relief are mounting, she says. “COVID was crazy. Ukraine has been insane. We used to get breathing room in between disasters to regroup. Not anymore.” Nonetheless, Smarinsky remains mission-focused. “It feels good to be able to help others. I always try to remember that one little individual.”


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Angels in Medicine is a volunteer site dedicated to the humanitarians, heroes, angels, and bodhisattvas of medicine. The site features physicians, nurses, physician assistants and other healthcare workers and volunteers who reach people without the resources or opportunities for quality care, such as teens, the poor, the incarcerated, the elderly, or those living in poor or war-torn regions. Read their stories at www.medangel.org.

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