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.