December 15, 2013

Once-condemned doctor turns to helping Haitians

Arthur Fournier published an early study on the mysterious autoimmune disease later identified as AIDS.

By Jennifer Kay
The Associated Press

NORTH MIAMI, Fla. – It may be hard to remember now, but there was a time when a mysterious autoimmune disease baffled doctors and frightened a world unfamiliar with what is now called AIDS. Arthur Fournier recalls the rise of the epidemic far better than most. In some ways it made him. In others, it nearly broke him. Above all, it helped define the rest of his life.

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Dr. Arthur Fournier stands in a North Miami clinic, as he discusses a time when a mysterious autoimmune disease baffled doctors and frightened a world unfamiliar with what is now called AIDS.

The Associated Press

In 1979, Fournier was a young doctor at Miami’s public hospital when patients exhibiting the symptoms of AIDS began flooding in – only these patients weren’t gay men, who accounted for many early cases of the disease. Rather, they were Haitian.

Confounded, Fournier and some of his colleagues soon published a study about what they were seeing among their Haitian patients, concluding “it is possible that this syndrome ... is the same as that found among homosexual men.”

Their work would go a long way toward helping the medical community better understand how AIDS spread, but it also had unintended consequences: Just being Haitian was initially listed by the federal government as a risk factor for AIDS, along with heroin use, hemophilia and homosexuality – a macabre “4-H club,” as it became known.

For years, discrimination and recrimination against Haitians ensued. Fournier and the other doctors were blasted for committing bad science, asking biased questions, failing to employ Haitian Creole translators when talking with their patients and targeting an immigrant community derided as “boat people.”

Now, some 35 years later, Fournier is one of the Haitian community’s biggest champions: A man whose early missteps led to a career dedicated to improving access to medical care for Haitians in Miami and back home.

“I think I believe in reincarnation, and I’m convinced he was Haitian in a different life, because he has given and done so much for Haiti and the Haitian community,” says Dr. Marie-Denise Gervais, a professor of medicine at the University of Miami who works with Fournier in a network of school-based health clinics.

Gervais, a native of Haiti, remembers feeling the stigma about Haitians and AIDS as she pursued her medical degree. For a time, even after a ban on Haitians donating blood in the U.S. was lifted, she stopped giving blood just to avoid being questioned about her heritage.

Gervais sees Fournier as a pioneer of the movement to improve health care for Haitians, not as the cause of the stigma.

“Looking back, obviously he wrote some article, but the scientific community had no clue. They’re seeing all these cases, and this is how the scientific mind works: You’re trying to put all the pieces of the puzzle together. When you’re right, it’s wonderful, but sometimes you have trial and error before you get it right,” she says.

From Fournier, now 65, there was never an “I’m sorry” for what happened in the aftermath of those early AIDS studies. Shortly before the research in Miami was published, officials at the Centers for Disease Control began warning doctors who cared for Haitians that their patients might be prone to terrifying infections.

In the panic that followed, Haitians in the U.S. reported losing jobs, and their children were taunted at school. The U.S. government would briefly ban Haitians from donating blood. Anger in the Haitian-American community manifested in massive rallies that blocked the Brooklyn Bridge and Miami streets.

Fournier, who endured pressure to cut back on his AIDS work, says he never felt like he had to apologize for contributing to the stereotype that shadowed Haitians for years. Rather, he says: “I did it with my words and actions.”

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