Physician, missionary now protecting state’s health

By Wayne Bryan Originally Published May 12, 2013 at 12:00 a.m.
Updated May 10, 2013 at 11:07 a.m.
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PHOTO BY: Rusty Hubbard

Dr. Nate Smith has recently taken over as interim director of the Arkansas Department of Health. Smith said filling this role is not something he had envisioned doing, but he is willing to serve wherever he is needed.

Monday was a busy day for Dr. Nate Smith of Alexander. He was moving into a new office and holding meetings as he spent his first day as interim director of the Arkansas Department of Health.

Smith first joined the Health Department in 2004, so he is familiar with the department’s mission to protect and improve the health and well-being of all Arkansans by providing more than 100 services across the state.

“This [job] is not anything I ever envisioned or aspired to,” Smith said from his ADH office in Little Rock. “I am willing to serve as long as I have this opportunity. God has his plan and purpose. I’ll just take it as it goes.”

Smith’s faith is a large part of his life and work. After a year of medical school, he stepped away for a year of study at a seminary. After they became physicians, he and his wife, Dr. Kim Smith, who now practices at Saline Memorial Hospital in Benton, served for several years as medical missionaries for hospitals in South America and Africa.

Smith said that in June he will be ordained as a deacon in a local Anglican church.

His new position with the state has already delayed some of Smith’s plans. He and his wife were set to return to Kenya in a few weeks, for a month at a hospital in Kijabe.

“It would not be the right thing to go for four weeks,” he said. “That could not be compatible for the goals of the office.”

However, the director does not rule out going for an extended stay while in office. He said the state health officer in North Dakota is a doctor that Smith first met while both were working in Kenya, and the North Dakota official has been able to continue to work with HIV patients in Africa.

“He has given me a vision of how to work out a relationship to stay in contact with doctors in Kenya so we can work together,” Smith said. “I hope and pray we have some opportunities.”

While he has been humbled by the honor of heading the Health Department, it might not be the most memorable event of 2013 for Smith and his family.

A long-distance runner, Smith competed in his 21st marathon on April 15 in Boston.

“I had finished the race about 25 minutes earlier, and I was just leaving the recovery area,” Smith said. “It’s where you get blankets, water, warm clothes and your medal, and I had just called my wife to let her know where she and the kids could meet me when I heard the explosions.”

Because of the way the sounds bounced around the skyscrapers of downtown Boston, he first thought it was the sound of a construction accident in the opposite direction from the race.

“As I was leaving the area, I heard someone say something about explosives, and I met up with the family, and we were looking to take the T [the Boston subway] back to the hotel. While waiting, there were restaurants where there was TV, and people were watching video of the explosions.”

Smith said he crossed the finish line about 20 minutes before the bombs went off, near where his family had been standing.

“I wanted to come back to Boston and show my family where I was born,” Smith said. “I don’t know that I will be back, but that has nothing to do with the explosions.”

Meanwhile, he is training for another long-distant event in two weeks.

Smith was born while his parents were studying in Boston. He said his father became a medical scientist, and that led to the family traveling around the world.

The family lived in Egypt and Zaire, then came back to the United States and lived in Arizona, then Texas, where Smith attended high school and went to Rice University.

“I had wanted to be a scientist, probably having something to do with health. I lived the sciences,” Smith said. “I was inspired after learning about Louis Pasteur. He was famous for pasteurization, but he was a chemist and microbiologist. He was more than a doctor.

After graduating from Rice, Smith attended the Baylor College of Medicine.

“I had returned from seminary and had been away from medicine for a year,” Smith said. “I walked into a classroom and sat next to two women in the second row, figuring they would be serious studiers.”

One of the young women would become Smith’s wife.

“It turned out we lived in the same apartment complex and took the same bus to school,” he said. “We became friends, we became best friends, and I asked her to marry me in our last year of medical school.”

In an earlier interview, Dr. Kim Smith said her husband shared his strong faith with her while they were in school, and also a desire to serve as a medical missionary overseas.

“We wanted to make an impact, and I liked working with pregnant women,” she said. “It was a chance to change the world, as Jesus did, one person at a time.”

The first foreign posting for the young Drs. Smith was Quito, Ecuador. They were both moved by the plight of the patients they treated.

After their first mission, the couple returned to Texas.

“Kim established her first practice as an OB-GYN and earned the certifications and fellowships that established her career,” he said. “I took advanced training in HIV and other infectious diseases.”

With their advanced training, Smith and his wife took a trip that both said changed their lives forever.

“In 1999, we when to Kenya as resident missionaries and doctors,” he said. “We wanted to go to a high-need area, and we were sent to Kijabe Hospital.”

Smith said the hospital was in need of two doctors: an OB-GYN and a general-practice doctor.

“Most of the patients in the hospital in Kenya [had] infectious diseases, so my training was right for the job,” he said. “It was four of the best and hardest years.”

While there, the couple adopted two of their four children.

While HIV and AIDS have fallen from the headlines in America, the disease has been a major plague in Africa. Smith said the disease was rampant when they first arrived, and major medical progress has been made over the years.

“Things are dramatically different now,” he said. “When we arrived, half the patients in the hospital were HIV positive, including in pediatric. It was very sad.”

When he first joined the hospital in Kenya, 12 percent of the mothers were infected with HIV. Now it is less than 5 percent. Smith said that in 1999, there were no medicines available for the treatments.

“Now 7,000 people are treated in a care network of satellite clinics in small towns and

villages across the country,” he said. “The road to the hospital was barely passable then — today it is a highway.”

When the Smith family returned to the U.S., they came to Little Rock.

“I had never been in Arkansas, but the Christian Medical Society said a group in Little Rock was looking for a doctor of infectious diseases,” he said. “I contacted the guys, and we got to know each other though email, but when they offered me a private practice with them, I said no.”

He remained in contact with the doctors of Infectious Disease Resources in Arkansas, and the Smiths were invited to visit in 2003. After he made rounds with the Arkansas doctors, they again offered Smith a job, and he accepted.

“We were planning on coming to Arkansas for a year at most,” he said, “but we stayed for four years after Kim was found to have breast cancer.”

For months, his wife underwent surgery, radiation treatments and chemotherapy. To have more time for his wife and family, he left his practice and joined the Arkansas Department of Health in 2004 as medical director of the Ryan White HIV/AIDS program, and he helped reorganize the infectious-disease branch of the department. Later, he was named state epidemiologist.

Yet the family returned to Kenya in 2006 when Smith received a grant from President George W. Bush for AIDS relief. While the couple practiced in Africa, his wife would return for checkups.

“During those years, there was a lot of unrest in Kenya,” he said. “Today things are better. They had a peaceful transfer of power after elections a few months ago. That was not possible earlier.”

The Smith family, who then had four children, returned to Arkansas in July 2009. His wife set up her practice in Saline County, and Smith returned to the Health Department and became deputy director for public-health programs. His children are in Bryant schools, and his oldest daughter, Penny, will return to Kenya this summer for the second year in a row as part of a mission group.

“Her ties to Kenya remain strong,” Smith said. “I can’t imagine us not going back, if not in 2014, then 2015. But I am committed to the department until we have got it covered.”

While his title is interim director, Smith said, he will continue to serve until a replacement is named by the governor of Arkansas.

“I love working here,” Smith said. “I don’t know how long I will be here, but if there is a search committee, I don’t know about it. I will serve where I am needed.”

Staff writer Wayne Bryan can be reached at (501) 244-4460 or wbryan@arkansasonline.com.

Tri-Lakes Edition Writer Wayne Bryan can be reached at 501-244-4460 or wbryan@arkansasonline.com.

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