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

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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

Growing up north of Boston, Fournier was the oldest of six children whose assembly-line worker father died at age 40. In medical school, he was keenly aware that he hadn’t shared many of the privileges enjoyed by most of his classmates – they were the sons of lawyers and doctors, while he was selling his own blood to help pay for the engagement ring he gave to the woman he courted with dates in the medical school cafeteria.

He wanted to work with the poor – circumstances he found familiar – and after completing his residency at the University of Miami hospital, he spent two years practicing medicine in rural Virginia. Fournier’s return to Miami to teach public health in 1978 coincided with the arrivals of thousands of Haitians, mostly by boat.

When these Haitians got sick, they lacked the money to go anywhere else but Miami’s public hospital, exposing Fournier for the first time to Haitian culture and AIDS.

“The people in the hospital, they were going nuts,” is how Fournier remembers those early days of the AIDS epidemic. He would step into elevators at Jackson Memorial Hospital to see orderlies dressed head to toe in protective suits just to transport AIDS patients, whom some residents refused to examine. When he got home from work his wife, terrified of infection, ordered him to shower before he did anything else.

Amid the criticism from Haitian community leaders that the doctors had failed in the most basic aspects of medical exams – simply asking their patients about their health – Fournier stood by his work and continued to treat Haitians and other patients with AIDS.

“I feel like they were my brothers and sisters,” says Fournier, who later published research about the socio-economic forces that helped HIV and AIDS spread worldwide. “It’s not really guilt, but I was extremely disappointed when ... our identification of HIV amongst the Haitians so led to their stigmatization. That was so wrong.”

Fournier and others in the medical community later would come to understand that poverty played a significant role in AIDS cases among Haitians, the homeless and other impoverished communities.

Prostitution and sexual tourism, drug use and social and political forces affecting women, families and minorities also facilitated the spread of AIDS. The most effective treatments and education about preventative measures such as condoms required large amounts of money and time from a limited number of doctors – resources often out of reach for the poor.

In the years that followed, Fournier focused on community health and finding new ways to provide health care for the homeless, immigrants and schoolchildren in South Florida, projects funded with more than $71 million in grants he secured. He served for 25 years as associate dean for community health at the University of Miami Miller School of Medicine.

In Miami’s Little Haiti, he participated in health fairs and helped fund a medical clinic at the Center for Haitian Studies. He developed a program to provide comprehensive health care to schoolchildren in Miami-Dade County’s impoverished, largely immigrant neighborhoods. Today, 11,000 students receive care that includes vision, dental and mental health services at clinics based in 10 area schools.

Fournier also invented a device that allows women to privately screen themselves for sexually transmitted infections, something that researchers who tested the device among Haitian women in Miami noted was valuable in a community still stung from the AIDS stigma and reluctant to divulge personal information to doctors.

The doctor worked to redeem his early mistakes with Haitians by becoming fluent in Haitian culture and Creole, the country’s most widely spoken language, says Marleine Bastien, a longtime Haitian-American advocate who has worked on health care issues in Little Haiti with Fournier since the 1980s.

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