The background, announcement and preparation of the referendum, the repressive actions of the State and different facts that took place on the voting day have been summarised in an annex at the end of the article.
Two days before the referendum, representatives of the National Police unions said publicly that they would guarantee that the vote would not be held but that ‘no one will hit anyone, it is simply a matter of guaranteeing the rights and freedoms of citizens, and no doubt that it will be done with the principles of congruence and proportionality . Bearing in mind that there were no precedents and, believing in the words of the police unions, nobody expected that on October 1 the actions of the Spanish police forces would be so violent, indiscriminate and disproportionate, applying incorrect and excessively aggressive use of police defences and using anti-riot means not permitted in Catalonia. In the many photos and videos that were immediately circulated, a large number of people were seen injured in polling stations throughout Catalonia . Among the injured there was a significant proportion of older people who, in fact, were not exerting resistance in the polling rooms.
On October 19th, an official report from the Catalan Health Service or CatSalut, the entity in charge of public healthcare in Catalonia, stated that 1,066 people had been affected by police charges . Most had contusions, but there were also serious traumas and, due to the strong emotional impact of the situation, anxiety crises and fainting fits were dealt with. Later on, more news and images of the events have been published showing the great scope and consequences of the police charges [2, 4]. The attacks have also been documented and/or condemned in various reports based on complaints made by the injured and on interviews with them and witnesses to the events [5, 6, 7].
Despite the evidence from the footage and reports, representatives of the Spanish Government and related media immediately began to deny the facts, and a year later they still do so. For example, they said that the images were fake, that the polling stations affected had been very few, that most people had been attended for psychological disorders, and also that the clinical reports did not reflect the truth [8, 9, 10, 11, 12]. They also justified police violence by claiming that voters assaulted police officers and this statement has been used by the prosecution against those charged in connection with the referendum .
The impact caused by the unexpected and violent police charges on citizens, the emergence of information denying or distorting the facts, the preservation of the doctors professionalism, the legal proceedings against all kinds of people and the assessment of the eligibility and proportionality of the police actions have raised the need, among other things, to learn more about the medical aspects of people attended to as a result of the police charges on the day of the referendum.
The objective of the study is to obtain, analyse and disseminate reliable quantitative and qualitative information on:
- The profile of the people attended to by CatSalut as a consequence of the police charges on October the 1st
- The amount, type, location and severity of physical injury from trauma or other causes
- The amount, type and severity of organic and psychological disorders secondary to the emotional impact of the situation
- The amount, type, location and severity of injuries sustained by police officers attended
Data on the people attended and their diagnoses have been obtained from the CatSalut Minimum Basic Data Set Register (CMBD) . CatSalut is in charge of all public healthcare for the citizens of Catalonia and has a network of centres with various types of health equipment. It includes hospitals, outpatient clinics and emergency services. Each medical act, performed by any centre or team, is registered electronically and attributed to each person attended to by means of their medical card number, unique for each Catalan citizen with the right to health assistance. Non-Catalan citizens are identified by means of their Spanish National Identity Document (DNI) or passport. The computer systems of the various health centres are set up in such a way that, once the information on each medical act has been entered, it can no longer be rectified. Information from the medical centres is periodically forwarded to the centralised register (CMBD).
Data of the people attended
The people attended between the 1st and the 4th of October as a result of the police charges that took place on October 1 have been included in this study. In the event that a patient was attended more than once, the various clinical notifications have been merged and, therefore, each entry in the register corresponds to a different person. The small number of cases in which age and/or sex were not recorded (6 in total), but a description of the clinical disorders was, were included in the study. On the other hand, cases in which the diagnosis referred to was ‘police charge’ or similar but the type of injury was not recorded were excluded from the study (6 in total).
The following data have been analysed for each person: age and sex, the day on which they were attended (the first time if they were visited more than once), the healthcare region and the centre or team of professionals who attended to each person. Diagnoses have also been analysed, both the physical injuries and the disorders caused by the emotional impact of the situation. The same data have been analysed in the study of the police officers attended.
Diagnostic definitions used
The diagnoses extracted directly from the centralised register (CMBD) have been prepared for analysis. Synonyms have been unified into one word or expression and some lesions or related disorders have been grouped into one. The diagnostic definitions used in this study can be found in the MedTerms Medical Dictionary , with some nuances and additions. The following:
-Polycontusions: not described in the dictionary; they are defined as the presence of two or more contusions in the same person.
-Wound: all types of wound found in the register have been included in this study: erosive, incisive, open, bruised, deep.
– Contracture: not described in the dictionary; state of permanent, involuntary stiffness or contraction of a muscle group or more that maintains the respective zone in a flawed position.
–Sensitivity disorders: the appearance of pain or dysesthesia secondary to trauma without the presence of lesions to the naked eye. Dysesthesia (not described in the dictionary): sensitivity disorder, especially of the touch, which can correspond to a decrease, an exaggeration or the increase of an unpleasant sensation by part of a normal stimulus.
–Concussion: a traumatic injury to the soft tissues, due to a violent blow, shaking, or twisting; a brain concussion can cause an immediate and often temporary impairment of the brain’s functions such as thinking, vision, balance and consciousness.
–Crisis of anxiety/anguish: both anxiety and anguish are defined as a feeling of unease and nervous tension that may be accompanied, especially in anguish, by neuro-vegetative organic symptoms; the term ‘crisis’ indicates that the disorder has occurred suddenly or acutely.
-Syncope: this diagnosis includes synonyms or similar processes such as: fainting fit, vasovagal episode, collapse.
RESULTS AND DISCUSSION
Number of people attended, day of care and healthcare centres
Of the total of 1,066 people attended to by CatSalut, 991 (93%) were assisted the same day, on October 1st and 75 (7%) on 2nd to 4th of October (Table 1). The patients were attended to by various teams of professionals: Medical Emergency System (SEM), Primary Care Centres and Ongoing Care Programme, Primary Care Emergency Centres and hospitals: a total of 92 teams or care centres throughout Catalonia. The data collected from all these centres were subsequently sent to the centralised register (CMBD).
Some media suggested that the number of people attended shown in the official CatSalut report did not reflect the truth and that patients with other conditions had been counted as injured by the police charges . Given that the computer systems of the health centres network and the CMBD, as explained in the Methods, are set up in such a way that they cannot be manipulated, insinuating that the number of people served by the referendum charges was false is like insinuating that a large part of the professionals in the 92 care centres had individually falsified the data.
On October 1, many people were attended to at the actual polling stations by the Medical Emergency System in the middle of the police charges, amongst the crowds and a great amount of injured people. In this context, health professionals prioritised the quality and effectiveness of their health care over the correct completion of data in clinical records, which were sometimes incomplete. The cases in which the diagnosis was not recorded were excluded from the study.
The number of people who were attended to in private centres or who simply decided not to seek medical assistance is unknown. In addition, it is possible that people with apparently mild psychological disorders were not attended until later, when the disorder became worse. Therefore, the number of people with medical problems on October 1 is, in all probability, higher than the 1,066 registered in CatSalut.
Number of people attended to in the various healthcare regions of Catalonia
The highest number of people attended was in the healthcare regions of Barcelona and its metropolitan areas, the most populated areas of Catalonia  (Table 1). However, there was an unequal proportion between the number of individuals and the number of people cared for in each region. Some regions, such as Barcelona and metropolitan areas North and South, Tarragona and Central Catalonia recorded a lower proportion of people attended in respect to their population, while in others, such as Girona and Lleida-Alt Pirineu and Aran, the proportion of people attended was higher. The greatest difference was registered in Terres de l’Ebre, where the proportion was 4 times higher than its population.
These results raise the following question: why were so many police officers and resources allocated to polling stations in the least populated areas of Catalonia if the main objective of the Police was to prevent the referendum? Some articles from October 2017 also questioned what the police’s criteria had been in selecting the schools where they should intervene  and a study with figures showed an inverse relationship between the number of inhabitants in the towns and the number of centres where the police were present . In this work, the charges were also related to the vulnerability of the population, according to the presence or absence of municipal police, health centres or fire brigades in nearby areas.
Profile of the people attended and number of diagnoses
Table 3 shows the data of the people attended grouped by age and sex, both those who requested assistance for physical injuries and those who requested it for disorders secondary to emotional impact. The majority of physical injuries were recorded in adult men (626 cases: 62.7%) and then in adult women (253 cases: 25.3%). It should be noted that there was a considerable number of men and women over 65 who had also been injured (78 cases: 7.9%), including 13 (1.3%) over 79 years of age. A girl under the age of 12 also suffered a contusion.
People attended for disorders secondary to emotional impact were fewer in number and belonged to all age groups except the 12-18 age group. Adult women predominated, followed by adult men and then women over 65. Analysing in more detail, it can be observed that men over the age of 65 (9 men) as a whole had less emotional distress than younger men (16 men) while women had similar distress in both age groups. This was probably related to the composition of the general population but it could also suggest that the elderly men who went to vote were highly motivated to do so and, therefore, more prepared psychologically to withstand a shocking situation.
In the total of 1,066 people attended, 1,221 diagnoses were recorded, that is, several people had more than one diagnosis (average 1.14). There are two major groups of diagnoses: 1,145 physical injuries and 76 disorders secondary to emotional impact. Among the physical injuries, there are 1,143 traumas and only a small number of injuries are by chemical agents: 2 conjunctivitis by pepper gas.
Traumas: number and type
In the footage released on October 1, many police officers are seen beating voters with police batons, often giving multiple blows and/or in unauthorised areas, and also kicking sometimes to people who have fallen to the ground. Police officers can also be seen throwing objects, pushing people, shaking them, throwing them to the ground or down the stairs, or dragging them by their extremities, ears, hair, neck and even their mouth . In some polling stations, rubber projectiles were also fired.
The total of the attacks described caused a total of 1,443 traumas, defined as internal or external injuries caused by external violence. There were 432 multiple traumas (29.9%), that is, at least 2 per person. This means that, in reality, there were many more traumatic injuries, at least 432 more. And, bearing in mind that the footage and reports often show that the same person is hit repeatedly, the actual number of injuries could be estimated at around 2,000, even if the exact figure is not known.
Traumas have has been classified into two main types:
- Those of non-specific location, i.e. in any part of the body
- Those specific to a part of the body, specifically the skull: traumatic brain injuries
A total of 1,109 non-specific location traumas were diagnosed (Table 4), all of which can be explained by the actions of police officers during the charges . The majority were contusions (920: 83.0%), i.e., bruises or hematomas without breaking the skin. This type of injury is typically caused, by the violent collision of a blunt object and, therefore, most can be attributed to blows with a police baton. Bruises can also be caused by rubber projectiles and falls. Further down are wounds or lesions with broken skin (97: 8.8%). Although not separately counted, some were wound contusions. Wounds can also be caused by falling or being dragged. Fractures and trauma to muscles, tendons and joints were much less common. Finally, 3.5% of sensitivity disorders due to trauma were recorded, mainly pain but also dysesthesias, without visible lesions, which can be explained by traumatic damage to peripheral nerve endings.
The most important location-specific lesions were 34 traumatic brain injuries (TBI). Unlike head contusions and wounds, which only produce an external injury, TBI injuries also affect internal organs as defined: traumatic organic or functional injury of the cranial content that can affect the areas of the brain responsible for movement, sensation, emotion, behaviour, attention, memory and language . Three of the TBI diagnosed presented complications: brain concussion, loss of consciousness and convulsions. TBI can be caused by a strong blow to the head, by concussion, or by a rubber projectile, as was the case of the most critical patient with a fracture of the bottom of the right eye orbit, destruction of the eyeball, and loss of vision. The TBI by concussion (recorded in the diagnoses of 6 cases) are caused when the person is subjected to a sudden or violent shake that leads to a rapid acceleration/deceleration movement of the brain that makes it hit the skull.
Traumas: location and multiple injuries
As mentioned in a previous section, the care of the injured took place in the voting centres in many cases, in the midst of police charges and, in these conditions, the staff of the Emergency Medical Service prioritised the quality of care over the correct completion of the clinical forms. This explains why in 179 diagnoses (12.4% of traumas), only the type of lesion was recorded but not the location (Table 4). Thus, when analysing the location of traumas in different parts of the body, this group was not taken into account, nor was the group of traumas in multiple parts of the body.
Traumas of known location were 532 in total. Figure 1 shows its distribution by corporal areas. The head and neck traumas were 137 including injuries of non-specific location (103) and TBI (34).
In the action protocols of the Mossos d’Esquadra force (Catalan Police), it is clearly defined how the police batons should be used: “The use of the police baton should be limited to one or two blows, short and dry. The blows must be given with the defence parallel to the ground and on muscle-protected parts of the lower body. In the event of an assault with a knife or blunt instrument, the articulation of the member of the body holding the weapon should be found. In no case the baton may be used from top to bottom or on vital areas of the human body, such as the head” .
The graph in Figure 1 shows that only 20% of the traumas took place in the recommended areas, i.e. in the lower extremity and gluteal area as muscle-protected parts of the lower body. The rest of the traumas (80% overall) affected areas at risk of complications in internal organs, especially in the head and trunk, both with a similar proportion, and in the upper limb with a slightly higher proportion.
As mentioned in a previous section, there were 432 multiple location traumas (29.9%), that is, in two or more body areas (Table 4). Published footage and reports [2, 4, 6, 7, 19] show that a certain number of people were repeatedly hit with the result of multiple contusions or polycontusions. In accordance with the aforementioned protocols for police action, the recommendation to give only 1 or 2 blows was not complied with either. Comparing the data in this study with the data in the CatSalut Report, the figures of polycontusions do not match. This is due to the fact that in the CatSalut Report the term ‘polycontusion’ was used to describe the combination of various pathologies in the same person .
The Spanish National Police Code, an 1986 organic law updated in January 2019 , contains all the regulations concerning the National Police but does not include specific instructions on the use of police defences. For this reason, the analysis of injuries in relation to the actions of police officers has been done with the instructions on weapons given to the Mossos d’Esquadra . This comparison is justified because both the National Police Code and the Mossos d’Esquadra Code of Ethics  are inspired by the Council of Europe  and United Nations General Assembly  same regulations on Police.
When analysing the specific locations within each part of the body in more detail, some are significant. For example, within the head and neck area there were 65 injuries to the face, most of them contusions, but also 2 fractures (not counting the ocular orbit floor included in TBI). Other significant injuries due to their location on the head, and also due to their severity, were the 34 TBI. Unlike scalp contusions (there were only 4), TBI require a strong impact on the skull, capable of injuring the organs inside it. Both facial and head injuries (12.2% and 6.4% respectively of trauma of known location), suggest a high degree of aggression and viciousness with the people hit. The act of causing injuries to multiple parts of the body, apart from aggravating the severity of the injury, also suggests similar attitudes.
The area of the trunk, which includes the thorax, shoulder, back with the spine, and pelvis, houses organs as important and fragile as the lungs, kidneys, or spinal cord. Fortunately, these vital organs were not significantly affected, although there were numerous injuries to the chest and back including a vertebral fracture. The upper limb is the part of the body that suffered the most trauma and also the most fractures. The arm was the most injured area but in the hand and fingers there were also contusions. The hand fingers specifically presented fractures, capsulitis and dislocations, which can be caused, among other actions, by twisting or excessive stretching of the fingers . The lower limb, despite being considered a less risky part of the body, also suffered some major injuries, especially an impacted femur fracture, which was one of the most severe cases.
Disorders secondary to emotional impact
In the set of photos and videos showing the police charges, it can be observed that the officers’ actions were, in general, very forceful and shocking, with profuse use of the defences against peaceful voters [2, 4, 19]. The sight of indiscriminate attacks of all kinds by a compact mass of uniformed policemen, often with their faces covered by the visor, the presence of wounded or bloodied people on the ground, and the screams of pain and fear from people at polling stations were reason enough to have a strong emotional impact all over the world. In addition, the actions of smashing doors and breaking glass and furniture added to a sense of insecurity and danger [6, 27]. In this situation, there were people who developed disorders secondary to the emotional impact received, in total 76 (Table 5). When we talk about emotional impact, we tend to think that it only produces psychological disorders but, in reality, there were a greater number of organic and mixed disorders (67) than pure psychological disorders (9). The latter were, in general, transitory and of little seriousness although this type of disorders sometimes manifest themselves in a delayed manner and it is possible that some were attended later than the days included in the study. A joint project of the universities of Lleida and Barcelona is carrying out research into the emotions and psychological consequences of the situation experienced on the day of the referendum .
Thirty-four diagnoses of anxiety/anguish crises, mixed neuro-vegetative organic disorders (dyspnea, palpitations, precordial pain, headache, dizziness, vomiting, among others) and psychological disorders (sense of danger, irritability, insomnia) were recorded. Nine people experienced dizziness or vertigo, but it cannot be ruled out that these symptoms corresponded to anxiety or anguish. The remaining diagnoses were cardiovascular organic disorders, mainly syncope (31 cases), which is a temporary loss of consciousness caused by low blood pressure and decreased cerebral blood flow. Other cardiovascular disorders, of growing severity, were: transient alterations in blood pressure (hypertensive crisis) and heart rhythm (tachycardia), paroxysmal atrial fibrillation, cardiac disorder requiring the implantation of a defibrillator and, in the most serious case, myocardial infarction with cardiac arrest.
Severity of the people attended
According to the October 2017 CatSalut report , the majority of people attended had mild injuries or conditions: 886 (83.1%). However, in 173 cases (16.2%) the diagnoses were of moderate severity and 7 people (0.7%) were classified as severe. These 7 patients were counted in the section of characteristics of the people attended and their diagnoses in the corresponding sections of physical injuries and emotional impact but, due to their importance, they are described separately indicating the combination of pathologies they presented [3, 29]. These 7 patients had:
- Impacted femoral subcapital fracture
- TBI with loss of consciousness
- TBI with fracture of the ocular orbital floor and right upper jaw with damage to the eyeball and loss of vision
- Numerous contusions and wounds
- Right shoulder trauma and right trapezium muscular trauma
- TBI and abdominal trauma with hypertensive crisis
- Acute myocardial infarction with cardiac arrest and multiple contusions
In some patients, the severity was due to the seriousness, extent and complications of the trauma, mainly in TBI. The prognosis was aggravated when there were multiple injuries and also with the addition of organic disorders by emotional impact. In the case of myocardial infarction, this disorder was the key factor in the patient’s severity.
Considerations regarding the actions of Spanish National Police and Civil Guard officers
On October 1, when citizens only wanted to vote, there were massive police charges in many polling stations, resulting in 1,066 people attended and 1,221 diagnoses made. They are summarised below:
- 991 people injured and 76 with disorders secondary to the emotional impact of the situation
- among the injured there were quite a few elderly people, some over 89 years old
- there were also minors, including a girl under the age of 12 with a contusion
- the most frequent trauma was contusions (63.8%), injuries typically caused by blows, and of these, almost half were located in multiple parts of the body
- trauma affected several areas of the face on 65 occasions
- some heavy blows to the head or violent shaking of the person caused 34 TBI, with lesions to the bones and brain
- most of the disorders secondary to emotional impact were of organic type, including an acute myocardial infarction classified amongst the 7 most serious diagnoses
- the other more severe cases were 3 of the TBI, 2 patients with combined pathologies and another with a complicated fracture
- the extent of pure psychological disorders is unknown because they frequently occur sometime later
The National Police Code, mentioned above , establishes some basic principles for the conduct of officers: they must act with absolute political neutrality and impartiality, they must adhere to proper and careful treatment in their relations with citizens and they must only use weapons in situations in which there is a rationally serious risk to their lives or physical integrity or that of third parties, or in circumstances that may pose a serious risk to public safety.
Comparing the outcome of police actions against the regulations governing the conduct of officers, some questions arise:
- Why did Spanish police officers carry out generalised police charges at polling stations where people were peacefully protecting the ballot boxes?
- Bearing in mind that there was no serious risk to anyone’s physical integrity or to public safety, why did they use the police defences instead of dealing with the citizens correctly?
- Why did they injure so many people, including the elderly and minors?
- Why did they use the defences heavily and indiscriminately, resulting in multiple injuries and lesions to unauthorised body parts, including many to the face?
- Why did they give so many hard blows to the head or make such violent shakes that they caused cranioencephalic injuries?
All these questions can be condensed into one:
- Why didn’t police officers follow their own basic principles of conduct?
Instead of behaving in compliance with protocols, the Police used totally disproportionate force and showed remarkable aggressiveness, viciousness and total indifference or empathy towards the injured. A typical example of this was found in a polling station in Lleida, where there was the patient with the acute myocardial infarction; the footage shows how the police continued the charges while he was being resuscitated, and how some people who were beaten even fell on the patient. .
The action protocols of all police forces are precisely intended to limit the use of force to avoid unnecessary injuries or, in any case, less serious injuries. However, to this day it is not clear exactly what orders the Spanish policemen received regarding their conduct at the polling stations, nor who gave the orders. On the other hand, the police officers were responsible for their own actions and, as explained in the National Police Code, officers will adhere to the principles of hierarchy and subordination but, in no case, due obedience may cover orders involving the performance of actions that clearly constitute a crime or are contrary to the Constitution or the laws.
A number of international institutions and organisations claimed that disproportionate violence was used during the police charges on the 1st of October. These included the Council of Europe Commissioner for Human Rights and Human Rights Watch [5, 6]. They also called for a swift, independent and effective investigation. As a result, Human Rights Watch, in its last annual report published a few days ago, criticised the fact that no police officer was convicted for the excessive use of violence during the referendum .
Injuries of police officers attended
A small number of police officers were also attended to by CatSalut (Table 6). Nine officers from the National Police, 2 from the Civil Guard, and 1 from the Mossos d’Esquadra, a total of 12. They were between the ages of 19 and 65 and all were men except one woman from the National Police. The injuries diagnosed were only mild contusions and none of the officers had emotional impact disorders.
Some members of the Spanish government and ever-supportive media had claimed that the number of police officers injured was very high, around 400, which was later significantly reduced . Nonetheless, some of the legal charges against those involved in organising the referendum have been based precisely on the fact that there were injured police officers. It is therefore essential to clarify how many police officers were actually injured and what kind of injuries they sustained. In the first place, when analysing the images of October 1 it can be observed that police officers were protected with boots, helmets with visors, vests and other anti-riot gear such as shields [2, 4, 19]. On the other hand, it can also be observed that the crowds at the polling stations did not attack any officers and, in any case, only shouted in fear and indignation. Secondly, only 12 police officers appear on the CatSalut centralised register. It cannot be ruled out that, sporadically, some citizens acted aggressively against police officers, but it must also be considered that with their forceful actions against people and the use of defences during the charges, they could also have caused injuries to themselves.
The Spanish Supreme Court’s Provisional Conclusions brief from the Prosecutor of Case 3/20907/2017 reduces the number of police officers injured to 93 and describes the assaults on the officers by stating the polling station and the identification number or TIP of each officer (crossed out on the public copy) . The brief states that the people were aggressive and caused injuries to several police officers. It describes that 6 officers were attacked, specifically 4, and that several more officers in each of two schools were also attacked, without mentioning what traumas they sustained. It also lists the National Police and Civil Guard officers who were ‘injured’ (43 and 17 respectively) and ‘wounded’ (20 and 10 respectively); the identification number (TIP) of none of the 10 ‘wounded’ civil guards, all at the same polling station, was not indicated (only the TIP of the officer who was commanding them). None of the listed cases of ‘injured’ and ‘wounded’ officers explain what injuries they suffered.
Finally, a description is given of 7 officers with specific traumatic injuries: 1 testicular trauma caused by kicking, 4 contusions, 1 wound caused by kicking, 1 fracture of the phalanx of a finger. With the exception of these 7 cases, it is difficult to know the number of police officers injured on the basis of the written data, since it does not explain how many of the attacked officers presented traumas or what type of injuries the officers had. In order to be able to clarify the real number of police officers with injuries, it would be of great help to provide the medical diagnoses of the officers who were attended to in health centres other than CatSalut.
To the Board of the Col·legi de Metges of Barcelona for the arrangements made in the Servei Català de la Salut (Catalan Health Service).
To the Department of Health of the Generalitat de Catalunya for their collaboration, without which it would not have been possible to carry out the study
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27. Cotobio V, Soares I, Clarke H. Hundreds injured as Spain cracks down on Catalan referéndum. CNN World, 01-10-2017.
28. Mombiela M. Investigació sobre els efectes psicològics del referèndum. Públic, October 10, 2017. https://www.publico.es/public/investigacio-els-efectes-psicologics-referendum.html
29. El testimoni colpidor de l’home a qui la policia espanyola va causar un infart l’1-O. VilaWeb, País > Principat, January 14, 2018.
30. Human Rights Watch, World Report 2019. pp. 237. https://www.hrw.org/sites/default/files/world_report_download/hrw_world_report_2019.pdf
Núria Pujol-Moix, Emeritus Professor at the Universitat Autònoma de Barcelona and Researcher at the Sant Pau Biomedical Research Institute (IIRB Sant Pau) in Barcelona.
Other scientific publications by the author can be found at the following link: https://www.ncbi.nlm.nih.gov/pubmed/?term=Pujol-Moix+N
ANNEX: THE REFERENDUM
In recent years, Catalonia’s long-standing fiscal deficit and Spain’s increasing centralising tendency have raised an awareness in Catalan society of being attended unfairly both economically and in self-government . There were certain expectations of an improvement in the text of the reform of the Statute of Autonomy approved in July 2006 but the Partido Popular filed an appeal of unconstitutionality. In June 2010, the ruling on this appeal , drastically lowering any expectation of improvement, considerably aggravated Catalan society’s negative perception of its relations with the Spanish State. And so, the Catalan sentiment of a large part of the population was transformed into a desire for independence ; this feeling also developed in a section of the population, generally of non-Catalan origin, which had previously felt Catalan . One of the effects of this situation was the gradual increase in the number of independence-minded MPs in the Catalan Parliament from 2015 onward.
The Parliament of Catalonia elected in September 2015, agreed, in the session of September 6th 2017, to carry out a binding referendum on self-determination in Catalonia and passed the law which was based on international law. A few hours later, all members of the government of the Generalitat de Catalunya signed the decree calling the referendum on October 1st 2017. On September 7th, the Constitutional Court admitted the appeal of unconstitutionality presented by the government of Spain against the law and the decree and cautiously suspended them [5, 6]. Legal experts stated that calling a referendum or participating in it was not a crime since the Spain’s criminal code was amended in 2005 . The government of Catalonia therefore proceeded with the preparations to hold the referendum on the 1st of October as planned.
The Spanish government made several efforts to prevent the referendum, which they considered illegal. They searched for the ballot boxes [8, 9] exhaustively and unsuccessfully and attempted, in any way possible, to prevent the voting from taking place by launching a great number of repressive actions [5, 10]: restrictions on freedom of assembly and expression, intervention of the finances of the Generalitat, intervention of numerous websites and telecommunications centres, fines on members of the Electoral Syndicate, investigation of the vast majority of mayors of Catalonia by the public Prosecutor’s Office and even temporary detention of some members of the Catalan government and some councillors. At the same time, the government of Spain sent 10,000 National Police and Civil Guards to Catalonia [3, 5] and, at the end of September, its president, Mr. Mariano Rajoy, threatened Catalonia with the words ‘They are going to force us to do what we don’t want to do’ .
On 27th September, the magistrate of the High Court of Justice of Catalonia instructed the police forces Mossos d’Esquadra (Catalan Police), the Spanish National Police and the Civil Guard, coordinated by a high official of the Ministry of the Interior, to close the public premises where the consultation was scheduled until 1st October, in order to prevent it . The magistrate’s indictment stated: ‘This inevitably entails adopting all measures to prevent the referendum from being held, without affecting the normal coexistence of citizens’.
According to statistics recently completed, the Mossos d’Esquadra closed 500 polling stations and the Spanish police officers closed 98 on the 1st of October . When the polling stations were protected by a large number of people, the Mossos did not intervene because they considered that they could not do so without charging and, therefore, without disrupting citizen coexistence. The same statistics explain that Spanish police officers intervened in a total of 114 polling stations and, in 75 of these, performed charges in order to confiscate the ballot boxes and ballot papers to prevent the voting.
According to the above information, the people of Catalonia were enormously motivated to participate in the referendum in order to achieve the independence of the country and, therefore, many volunteers helped in the preparations for the referendum. They bought, transported and concealed the ballot boxes  and, a few days before the voting, they occupied the polling stations en masse in order to avoid their closure . On the day of the referendum, the citizens led the polling stations, voted, and protected the ballot boxes with their bodies. In addition, many IT volunteers worked hard to ensure the universal digital census was available throughout the day .
1. Ten years since the disaffection: Montilla’s warning that went unheeded. Ara.cat, Editorial, August 16, 2017. https://www.ara.cat/en/Ten-disaffection-Montillas-warning-unheeded_0_1852014840.html
2. Statute of autonomy. Generalitat de Catalunya.
3. Puigdemont C, Mouton O. La crisi catalana, una oportunitat per a Europa. La Campana, Barcelona 2018.
4. La República de los no-independentistas, #NousRepublicans. Nautilus Comunicació i Cultura SL, Banyoles 2018.
5. Síndic, el Defensor de les Persones. The violation of fundamental rights and freedoms arising from the criminal justice reaction following October 1, and application of aritlce 155 of the Spanish Constitution. May 2018. http://www.sindic.cat/site/unitFiles/5324/Report%20on%20violation%20of%20fundamental%20rights%20and%20freedoms%20arising%20from%20October_1_eng.pdf
6. Govern.cat. Primer d’octubre, informe d’una repressió #240. October 2018. https://govern.cat/govern/docs/2018/10/04/15/48/c1ddabd0-fbdf-4a92-ae64-66ada9cf925f.pdf
7. Anàlisi jurídica de les suspensions de normes catalanes sobre el referèndum d’autodeterminació. https://acddh.cat/informes/analisi-juridica-de-les-suspensions-de-normes-catalanes-sobre-el-referendum-dautodeterminacio/
8. Dowsett S. Police in Catalonia hunt for hidden ballot boxes in bid to foil referéndum. Reuters, World News, June 11, 2017.
9. Güell O. Ballot boxes: Catalonia’s best-kept secret. Thousands of people in region coordinated activities to ensure equipment got to polling stations El País, Catalan bid for independence, October 03, 2017. https://elpais.com/elpais/2017/10/03/inenglish/1507025882_591932.html
10. Summary Report of actions taken by the Catalan Ombudsman regarding the day of October 1, 2017. November 2017.
11. Referéndum 1-O. Rajoy amenaza a la Generalitat: “Nos van a obligar a lo que no queremos llegar”. Público, Política, September 15, 2017.
12. Tribunal Superior de Justicia de Cataluña, Sala Civil y Penal. Diligencias previas 3/2017. https://www.ara.cat/2017/09/27/0_ORDEN_FUERZAS_Y_CUERPOS_DE_SEGURIDAD_-5.pdf?hash=484f0d08256e2fa90daf8dddfc0b50cb50498550
13. Catalonia 1 October 2017. Geolocated graphic memory of a day that we will never forget https://catmemoria.cat/en/
14. Catalans occupy polling stations before referendum. Pro-secession supporters camp out at Barcelona schools to defy Madrid authorities before Sunday’s independence vote. Aljazeera.com, News, Catalonia, September 30, 2017.
15. The great Catalonian cyberwar of 2017. The Washington Post, DemocracyPost, Opinion, October 18, 2017. https://www.washingtonpost.com/news/democracy-post/wp/2017/10/18/the-great-catalonian-cyberwar-of-2017/?utm_term=.734918bf843c
*The translation has been reviewed by the author Núria Pujol-Moix
Catalan version: VilaWeb @VilaWeb
Spanish version: Col·lectiu ComuniCATs @comuni_cats
Traducció (CAT-EN) – A case-by-case study that analyses the severity of the 1,066 injured from 1-O by Núria Pujol-Moix
— Col·lectiu ComuniCATs (@comuni_cats) 26 de gener de 2019