On October 1st, 2017, a non-authorized referendum on self-determination took place in Catalonia. The Spanish police forces carried out indiscriminate charges that injured numerous people. An official report from the Catalan Health Service stated that 1,066 people had been injured. The report was of an administrative nature and some aspects were not fully detailed. Moreover, the report didn’t make any kind of medical analysis. With the help of the Board of the College of Physicians of Barcelona, I obtained all the data of the injured people and carried out and published the study “Descriptive statistics of the people attended to by the Catalan Health Service as a consequence of the police charges on the day of the referendum on self-determination in Catalonia on October 1st 2017”. The aim of the present Opinion Article was to publicize the main results of the study to the scientific community and highlight the importance of the medical approach in the assessment of police violence. When including all the details and their critical analysis the impact of the police violence on the civilian population was much more significant than previously thought. It was also assessed that the police had acted with great violence and viciousness, as the following data show:
a) More than a third of the traumas occurred in multiple body areas
b) There were 34 traumatic brain injuries
c) There were 65 injuries to the face
d) About 80% of the lesions occurred in unauthorized body parts by the ethical code of police.
Keywords: Contusions; Multiple Trauma; Traumatic Brain Injury; Face Injury; Police Violence; Self-Determination Referendum; Catalonia
Abbreviations: Cat Salut: Catalan Health Service; CMBD: Centralized Register of Cat Salut; TBI: Traumatic Brain Injury
On October 1st, 2017, a non-authorized referendum on selfdetermination took place in Catalonia. The Spanish police forces carried out indiscriminate charges in various polling stations. In the many images and videos that were immediately broadcasted, many peaceful citizens, sometimes elderly, were seen injured . Many police officers were beating voters with police batons, often giving multiple blows, and occasionally kicking people who have fallen to the ground. Police officers also pushed people, threw them to the ground, down the stairs or dragged them by their extremities, ears, hair, neck and even their mouth. Despite the evidence from the footage, representatives of the Spanish Government and related media immediately began to deny the facts. For example, they said that the footage was fake, that most people had been attended for psychological disorders, and that the clinical reports did not reflect the truth. They also justified police violence by claiming that voters assaulted police officers and this statement has been used by the prosecution against all those charged in connection with the referendum.
The brutal police violence that the images and videos showed made a huge impact on me. And, as a doctor, I asked myself several questions, e.g. how many people were injured? What was the proportion of elderly people injured? Had there been many head injuries? An official report from the Catalan Health Service (Cat Salut), the entity in charge of public healthcare in Catalonia, answered some of these questions . The report stated that 1,066 people had been injured. Most were adult men but there were 13 people over 79 years of age and 2 children under 11. The most frequent lesions were bruises and, to a lesser extent, other physical injuries and disorders by emotional impact. There were 7 people with a serious prognosis, suffering from multiple traumatisms, traumatic brain injuries and a myocardial infarction. However, the report was of an administrative nature and didn’t make any kind of medical assessment or analysis. In addition, the diagnoses were incomplete, and the location of such injures was not described in detail. Therefore, I decided to conduct a study with the following objectives:
a) To obtain the missing information in the Cat Salut report and,
b) To perform a critical analysis of all existing data from a medical perspective. I thought this study would be useful to counter false news and assess the proportionality of police violence.
With the help of the Board of the College of Physicians of Barcelona, I managed to get all the data (except for the identifications) of the injured people and all of the diagnoses from the centralized register of Cat Salut CMBD . With this information I was able to carry out the study “Descriptive statistics of the people attended to by the Catalan Health Service as a consequence of the police charges on the day of the referendum on self-determination in Catalonia on October 1st, 2017”. The study was published in the Catalan newspaper Vila Web  and then published in English on the Comunicats. cat website . Our study provided new information that had not been included in the report carried out by Cat Salut. When including all the details and their critical analysis I was really surprised to see that the impact of the police violence on the civilian population was much more significant than I had previously thought. The most noteworthy results are summarized below:
a) In the total of 1,066 people attended, 1,221 diagnoses were recorded, that is, several people had more than one diagnosis.
b) There were 1,109 non-specific location traumas, most of them contusions (920: 83%) and, to a lesser extent, wounds, fractures, soft tissue injuries and post-traumatic local pain.
c) More than a third (432) of the non-specific location traumas occurred in multiple body areas.
d) There were 34 Traumatic Brain Injuries (TBI). Unlike scalp contusions, TBI require a strong impact on the skull, capable of injuring the organs inside it.
e) The location of the traumas was as follows: head and neck 25.7%; trunk (except gluteal area) 25.4%; upper limb 28.8%; lower limb (plus gluteal area) 20.1%. That is, about 80% of the lesions occurred in unauthorized body parts by the ethical code of police.
f) By analyzing some locations in more detail, it is worth noting that there were 65 injuries to the face, most of them contusions, but also 2 fractures.
The critical analysis of the injuries carried out with a medical approach allows us to conclude that police officers did not follow their own basic principles of conduct since they gave multiple blows and struck unauthorized areas. In addition, the large number of facial and TBI injures suggests a high degree of aggression and viciousness against the people they were hitting. This inappropriate behavior by the police force will need to be assessed in relation to the Spanish government’s unclear intentions regarding the population of Catalonia.
Thank you very much to Anna Odena for her revision of the English version
Conflict of Interest
- (2017) Catalonia 1st October 2017. Geolocated graphic memory of a day that we will never forget.
- (2017) Cat Salut (Catalan health service), Department of Health of the Generalitat of Catalonia (2017). Report about the incidents between the 1st and 4th of October 2017: patients attended to during the electoral and latter days as a consequence of the actions of state police bodies. 19 October 2017.
- (2019) Cat Salut. Servei Català de la Salut. Conjunt mínim bàsic de dades CMBD.
- Pujol-Moix N (2019) Estadística descriptiva de les persones ateses pel Servei Català de la Salut per les càrregues policials el dia del referèndum d’autodeterminació de Catalunya, l’1 d’octubre de 2017. VilaWeb 2019 Jan 24; Sect. Paí
- Pujol Moix N (2019) Descriptive statistics of the people attended to by the Catalan Health Service as a consequence of the police charges on the day of the referendum on self-determination in Catalonia on October 1st, 2017. ComuniCATS 2019 Feb 24; Sect. CAT EXTERIOR/COMUNICATS.