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THE FARE AT Helping Hands soup kitchen on Tuesday included spaghetti, tomato and onion salad, bread, a fresh peach and iced tea. And a side dish that was very special: an inaugural visit to Helping Hands by Columbus Hospital's Wellness Wagon.

The Wellness Wagon is a converted recreational vehicle, staffed by a medical team that seeks out the poor and the sick, and tests and treats them without charge.

Malnutrition, diabetes, ulcers, and high blood pressure often afflict the poor. Diet and worry are direct causes.

Poor children suffer most because they begin life on an uneven playing field, especially in Buffalo where the infant mortality rate is one of the highest in the nation.

Among people who live around Columbus Hospital, the infant death rate ranks with that of the Third World. On the Lower West Side, it's 19.9 deaths per 1,000 births. Just across the river, the infant death rate is 9.6 per 1,000 births -- a statistic that should underscore our national shame.

The people at Columbus attribute the neighborhood's high infant death rate to poverty and to a lack of prenatal care for mothers. Mothers who suffer from malnutrition don't have healthy babies.

The visit Tuesday to the soup kitchen at 382 Massachusetts Ave. by the Wellness Wagon was the hospital's way of showing the flag and its new image.

Columbus opened 80 years ago to look after the needs of the waves of Italian immigrants -- many of them dirt poor -- who moved into the neighborhood then known as "The Hooks." But when they prospered and many of them moved away, Columbus -- "the poor people's hospital" -- lost its sense of mission and fell on hard times.

Its darkest hours came in the early 1980s, when the Health Systems Agency pushed to have the facility closed because hospitals that catered to the poor were not economical. And many experts agreed. Births of babies whose mothers did not receive prenatal care are about three times more expensive than normal deliveries. People without health insurance who are shot, stabbed or mugged also add to hospital costs.

But Columbus was saved by the community's indignation and its refusal to accept the proposition that the poor were not entitled to neighborhood medical care.

Given a stay of execution, Columbus rediscovered its role as "the poor people's hospital." This was partly because the hospital hired Sushil C. Sharma as its innovative president and chief executive officer.

Sharma took Columbus back to its roots by tailoring its facilities to meet the medical needs of the new migrants, the Puerto Ricans, whose problems include hunger, joblessness and all of the ills that once plagued the immigrants from Italy. And more, including drugs and desperation.

Now a full-service hospital but with emphasis on today's medical problems -- such as alcohol and drug detoxification and a future emphasis on alcohol and drug rehabilitation -- Columbus has again become a player in the community, right down to its sponsorship of a children's baseball league. It also is working on a job-training program.

Sharma's Wellness Wagon is a manifestation of the "new" Columbus. In five years of patrolling streets and seeking out the sick, it has cared for nearly 7,000 people -- many of whom can't afford hospitals.

When the Wellness Wagon pulled up at Helping Hands, its staff was kept busy for nearly two hours examining many adults and children who couldn't remember the last time they had a medical examination. Those who were diagnosed as requiring additional treatment were given referrals to Columbus where, if they can't pay, they won't be turned away, according to Sharma.

When the Wellness Wagon left with the promise that it will return regularly, Helping Hands' director Sonny Miano was left beaming and ecstatic.

"You could tell that this was a real shot in the arm to our clients," he said. "It's not often that somebody comes up to them and tells them, 'I care.' "

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