Five months ago, Manuel Zúñiga went to a hospital in Bushwick, Brooklyn, because of incessant pain in his right hand. The Ecuadorean man had suffered a serious wound in that hand three years earlier – a circular saw had cut his tendons and bone – leaving him with a deformed finger and barely able to move his arm, and thus preventing him from working.

Zúñiga did not find the help he sought at the hospital nearest him, Woodhull Hospital, in Bushwick.

"I kept going back there for about a month," Zúñiga recalls. "The doctors couldn't tell me what the problem was, and then they sent me to a therapist, still without knowing what it was. Finally they told me, 'We can't help you here. If you want to, go into Manhattan,'" he says.

In spite of the fact that there are two hospitals in Bushwick, it is not unusual for residents to have to travel to other neighborhoods to get the medical care they need.

This is a glimpse of a much wider problem faced by this heavily populated neighborhood in north Brooklyn, much of it Hispanic, which lacks many basic services.

One of the causes of this situation is the low level of participation in the 2000 Census by the residents of the area. The federal government distributes funds yearly in accordance with the population of each area. If there has been a lack of participation in the Census, a neighborhood can experience cuts in its budget for services and benefits, as well as of its representation in Congress.

In 2000, Bushwick was one of the worst-counted Hispanic barrios in the entire city. In the southern part of the neighborhood, fewer than 40 percent of the residents returned the Census form to the agency's offices. Brooklyn was also the borough with the lowest level of participation, making it one of the hardest-to-reach counties in the entire country.

"Bushwick services were clearly affected by the low count in 2000," states Nadine Whitted, manager of Community Board 4, which represents the Bushwick and Ridgewood neighborhoods. "Every time there's a low count we don't get the services we all need so all of us here are affected, whether we are documented or undocumented, because we all have the same needs," Whitted points out. She thinks the fear of deportation is the main reason why residents refuse to participate.

Besides the hospitals and other medical centers, other services that depend on federal funds are the schools, public housing, food stamps, and sanitary and transportation services.

Services diminish

A lack of services is one clear proof of the way the low count has affected this area negatively. Bushwick has about the same level and number of services as another Brooklyn district that includes Park Slope, Carroll Gardens, Gowanus and Red Hook, according to data from the city's Planning Department. In 2007, the two districts had approximately the same number of public schools and the same number of preschool and extracurricular programs. If one bases these facts on the Census 2000, they make sense: the two districts each reported having some 104,000 residents.

According to American Community Survey, a national census poll taken in years when there is no census count, Bushwick's real population in 2008 was over 128,000. Of these residents, approximately 87,000 were Hispanic. The Park Slope district had a population slightly over 113,000.

This poor count is a problem for Bushwick, where more than 51,000 persons depend on public assistance, more than triple the rate in Park Slope.

It is no coincidence that the poorest neighborhoods have the worst services, maintains Alvin Avilés, director of the local Census office in Bushwick.

"The Census creates a cycle. Precisely because there was a low count in 2000, we desperately need this [federal] assistance, more than ever," he assures us. "When I talk with people about the importance of the Census, I ask them: How long do you have to wait in the emergency room or to see a doctor? I try to emphasize that this is directly related to the Census numbers," he adds.

At Woodhull Hospital no one wanted to comment. But Rajiv Garg, president of Wykoff Medical Center, the other hospital in Brooklyn, says that the hospital is struggling to provide services.

"The more people who come in who cannot pay, the harder it is for us to attend to their needs. Imagine it as a meal and dessert! Dessert is what we lack in this community. The patients are not satisfied," he says.

The hospitals are overburdened because of the lack of clinics for the uninsured or undocumented, explains Theo Oshiro, director of health programs for Make the Road NY, a nonprofit immigrant rights organization. As a result, people go to the hospitals where they have to put up with long waits in the emergency room – up to seven or eight hours – and waits of as long as a month for an appointment to see a doctor.

Congresswoman Nydia Velázquez (D-NY District 12), who represents the area, comments: "The residents of Bushwick were counted low in the Census 2000. A just and equal count will ensure that we receive the essential resources for schools, medical care, infrastructure and job training."

Vito López (D-Brooklyn), the State Assemblyman for the district, points out: "There was a low count in all minority and Latino communities in 2000 and we lost funds as a result." "If this money had come to the district it would be a different story. It is imperative that we all get counted in order to raise the amount of money we get," says López. "The hospitals have to get these benefits," he points out.

It is clear that the health of thousands of people in Bushwick is at stake in the Census 2010.

"I've had this problem with my hand for five months now," laments Zúñiga, the Ecuadorean who travels into Manhattan in order to see a doctor. "After five months, they're now going to do the first test to determine what is going on. I'm in pain all the time and I'm not taking anything for it, but what am I going to do?" he asks.

The Census form

This month, a 10-question form from the Census Office will arrive at your home. When you get the form, you are asked to respond to the 10 questions and mail the form back, before April 1, in the postage paid envelope provided. Your identity and the information you provide are protected by federal law. By the same token, there will be no questions about your legal status. If you do not return the completed form, you may be visited by an employee of the Census Office, generally someone from your community who will come to your home to obtain the information required on the census form.