GNU HEALTH HMIS 3.6 series released

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Dear community:

I am very proud to announce the release of the GNU Health 3.6 series !

This version is the result of many developments and integration of ideas from the community.

We are now 11 years old. We should all be very proud because not only we have built the best Libre Health and Hospital Information System, but we have created a strong, committed and friendly international community around it.
What is new in GNU Health 3.6 series

  • Both GNU Health client and server are now in Python3
  • Remove Python2 support
  • GH HMIS server uses Tryton 5.0 LTS kernel (5 year support)
  • Client is based on Tryton GTK client 5.2
  • Automation on the GH Federation queue management
  • Integration to Orthanc DICOM server
  • Pages of Life models fully integrated with patient evaluation & GH Federation
  • GNU Health camera plugin integrated with the latest OpenCV
  • GH Client uses GI. Removed pygtkcompat.
  • GH Federation HIS has been migrated from MongoDB to PostgreSQL
  • New demo database downloader
  • Thalamus uses now uwsgi as the default WSGI
  • SSL is the default method for Thalamus and the GH Federation

Upgrading from GNU Health 3.4

  • Make a FULL BACKUP your kernel, database and attach directories !!!
  • Follow the instructions on the Wikibooks
  • Read specific instructions found under scripts/upgrade/3.6 of the main source installation tarball, an apply the scripts in the specified order.

Development focus

In addition of the GH HMIS server, we will focus the development in the following areas of the GNU Health ecosystem:

  • The GNU Health Federation Portal
  • The mobile client
  • Interoperability

The GH Federation Portal has already started. It is a VueJS application and provides a single point of entry for individuals, health professionals and epidemiologists to the GNU Health Information system.

The GNU Health Federation now receives information coming from many health institutions and people from a region or country. The GH Federation portal will allow to manage resources, as well as the main point for analytics and reporting of massive amount of demographics health data generated nationwide. People, health centers and research institutions (e.g. genomics) already can enjoy the benefits from the GNU Health Federation.

The mobile client (MyGNUHealth) development will remain in QT and will be focus on KDE plasma mobile technology, and run in Libre mobile operating systems and devices (such as Pine64). We need fully libre mobile devices if we want to preserve privacy in healthcare.

As far as Interoperability goes, GNU Health is now very interoperable. It uses open coding standards, as well as open formats (XML, JSON, .. ) to exchange messages. We currently have support for read operations in HL7 FHIR for a number of resources. Needless to say, we are open to other open standard communities that are willing to integrate to GNU Health.

Last but not least….no matter how hard we try to avoid them, there will be bugs, so please test the new system, upgrade process, languages, and give us your feedback via them via health@gnu.org

Happy and Healthy Hacking !


Dr. Luis Falcon, M.D.
President, GNU Solidario
GNU Health: Freedom and Equity in Healthcare
https://www.gnuhealth.org
GNUPG Fingerprint :ACBF C80F C891 631C 68AA 8DC8 C015 E1AE 0098 9199

GNU Health: 10 years of Freedom and Equity in Healthcare

Update: Last year (May 2018), the FSF asked me to write a post about GNU Health. Finally, here it is !


May 2018

social_medicine

Health is a non-negotiable human right. Access to quality healthcare must be public and universal.

I am back from my trip to India, where I spent a week with the team of All India Institute of Medical Sciences – AIIMS –, the largest public hospital in Asia and a leading research institution. They have taken the decision to adopt GNU Health, the Free Hospital and Health Information System.

One key aspect in Free Software is ownership. From the moment they adopted GNU Health, it now also belongs to AIIMS. They have full control over it. They can download and upgrade the system; access the source code; customize it to fit their needs; and contribute back to the community. This is the definition of Free Software.

The definition of Free Software is universal. GNU Health is equally valid for very large institutions, national public health networks and small, rural or primary care centers. The essence is the same.

GNU Health as a social movement: GNU Health is a social project with technology behind. It’s about Social Medicine and delivering universal healthcare. It’s about social activism. One of the main reasons that led me to create GNU Health were the tremendous inequalities in access to healthcare. Over 20000 children die every day from preventable, social diseases. To name a few : malnutrition, contaminated water, child slavery, prostitution, war, malaria, HIV-AIDS, tuberculosis, dengue and other neglected tropical diseases. These are causes and/or results of social diseases, conditions that have a higher impact and higher prevalence on the poor and the underprivileged.

Studying and getting a deeper understanding on the living conditions of people in rural areas and in urban ghettos around the world, reinforced my intention to write a system that included the socio-economic determinants of health and disease. Most of the time, health (and the lack of) is determined by the environment, and biology plays a lesser role. Proper nutrition, housing, sanitation, access to education and to primary healthcare are key for the dignity, development and health of the individual, family and society at large. I like to summarize it as “people before patients”.

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GNU Health implementation at Laos CMR Public Health hospital (CC BY-SA 4.0 GNU Solidario )

Nature and Nurture: Having Social Medicine on its DNA does not stop GNU Health from also working on the molecular basis of health and disease, precision medicine, bioinformatics and genetics. For instance, we incorporate state-of-the-art information from Unitprot containing thousands of gene natural variants involved in human disease. The bio-psycho-social GNU Health approach makes personalized medicine possible, and it builds the bridge between the clinician and the research institution, to better understand and fight multifactorial conditions such as Alzheimer’s disease or cancer. Both nature and nurture are present in GNU Health.

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GNU Health – Freedom and Equity in Healthcare

Trans-disciplinary team: GNU Health works at different levels. Social workers doing prevention in the field; health professionals taking care of the patients; Administrative team dealing with stock, human resources, finances and other internal health institution processes; and the ministry of health improving health campaigns based on the collected data. All these processes and tasks are interconnected, and the result of others.

The fight for Public Health System: I am observing how many countries are dismantling the Public Health system in favor of private corporations. This is not only sad, it is a crime. The only way we can guarantee proper and universal health care is by maintaining the Public Health system. Privatization of the public healthcare is evil, creates a health system for the rich, and excludes the underprivileged that can not afford insurance costs. Let me be very clear: healthcare is just a business for the corporation. Dr. René Favaloro said “Medicine without humanism is unworthy of being practiced”. I am not against the small private doctor office, that is complementary to the public health system. I am condemning the destruction of the current public health system, and putting it on the hands of large corporations that only care about money.

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GNU Solidario first project. Santiago del Estero 2006 . (CC BY-SA 4.0 Luis Falcon)

Public Health is a public good, so, as a result, anything related to public health should also be public. It is a contradiction to have proprietary software running in the public health system. Not only is contradictory and unethical, it poses many dangers to privacy and security of the individual health information. Private software is a black box. We don’t know what happens when a medical evaluation is recorded. Where else does this data go? Who can access it ? We simply don’t know, because we can not see the code behind the action.

Niños de una escuela de Camerún

Children in a Cameroon rural school (2018 CC BY-SA 4.0 Luis Falcon)

Collective Freedom and ethical software: Free software is a philosophy based on community, cooperation and solidarity. We all benefit from the work, effort and talent of others. GNU Health uses many Free Software (operating systems, programming languages, database engines, encryption libraries, etc.). Moreover, GNU Health is today the result of the contribution of many people and institutions. We must be grateful to the community, and make sure that nobody breaks the evolution chain. This is where the concept I call “collective freedom” comes into play. People or companies that take the work of others, and purposely make it non-free are breaking the chain of evolution. They have taken advantage of the good will from the community to lock-in them in. Purposely obfuscating the code, not providing upgrade scripts, hiding documentation are ways violating the “collective freedom” and making a system non-ethical. That is one of the reasons we differentiate between Free Software philosophy, which is ethical by definition, from “Open Source”, that has a more pragmatic approach to programming. Richard Stallman wrote an article “When Free Software depends on nonfree” (https://www.gnu.org/philosophy/when-free-depends-on-nonfree) , related to this concept. For Spanish speakers, you can read my article “El Software Libre no se Mancha” (http://www.rebelion.org/noticia.php?id=233717 ), also related to this concept of Collective Freedom.

Ten years of Freedom and Equity in Healthcare: During this 10-year period, we have seen GNU Health adopted in many different scenarios: Primary care centers and academic institutions in Argentina; in the tropical rainforest of Cameroon; Infectious diseases laboratory in Gabon; the eHealth system in Jamaica Ministry of Public Health; The Center for Physical Rehabilitation in Laos taking care of UXO victims; Red Cross hospitals in Mexico or the largest public hospital in India and Asia. They are all different contexts and peculiarities, yet they all share the same spirit, that is, delivering Freedom and Equity in healthcare to the people.

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GNU Health at the United Nations – International Institute for Global Health

Let’s celebrate this 10 years of GNU Health, a social movement with technology behind. Let’s keep on fighting for health to be a non-negotiable human right.

 

 

Reconocimiento OpenAwards 2019 en Medicina y Ciencia

Hoy me siento honrado con este importante reconocimiento en OpenExpo 2019 , el mismo Día mundial de Refugiado .Se lo dedico a ellos y a los profesionales de la Sanidad Pública, que día tras día defienden la Salud como un derecho humano no negociable. Seguiremos trabajando por GNU Health y por llevar dignidad y salud alrededor del mundo.
Openaward 2019a Luis Falcon en Medicina y Ciencia

 

My trip to Haiti, the land of the free and the brave

I am coming back from my trip to Haiti.
I was invited by our GNU Health representative in Haiti, Augustin Pierre Michel.
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Handmade GNU Health shirt from Haiti

Haiti is a country of  brave men and women who stand strong fighting for their dignity.
A friend of mine from Jamaica told me once to dig into the history of Haiti, and the importance it had  in the freedom of human kind.
I found particularly captivating the  article “Our debt to Haiti”, from Sir Hilary Beckles[1]. A passage from that article:

This is what happened exactly 200 years ago: Jamaica is bursting at the seams with 300,000 enslaved Africans. Haiti is the only true land of the free and the brave, having defeated in battle the enslavers of France, Britain, and Spain before becoming in 1804 the first free state in the western world.

President Jean-Jacques Dessalines, enshrined within the 1805 national constitution, the most humane and politically powerful provision: Any enslaved person of African descent who arrives on the shores of Haiti is automatically freed and a citizen of Haiti.

Quick digression.. After reading this article, I would love Mr. Jean-Jaques Dessalines to reincarnate and to sit down with all the politicians that want to build walls of shame, and give them a lesson of humanity and ethics.
Two hundred years afterwards, over 40 million women, men and children are victims of modern slavery[2]. The modern world has slavery, slave owners and  “human properties” . Just look at what is happening in the Mediterranean and how migrants are abused and raped in Libya concentration camps. Another way of slavering is how children are used in clothing factories in Bangladesh, that make billionaires in Europe. Appalling.
The Freedom passage
Going back to the history of Haiti …
The Freedom passage named the 170 miles that separated those 300,000 slaves from freedom. The distance between Jamaica and Haiti.
Thousands of women, men and children would risk their live to reach freedom. Similiar to those who do it daily trying to cross the Mediterranean sea in Europe or the Rio Grande in America.
GNU Health mission in Haiti
Back to Haiti… I stayed at Hopital Bon Samaritain (HBS) in the city of Limbé, where we shared time with the colleagues at the hospital. The health institution not only serves as the reference hospital in the region, but also, as a orphanage. The work they do in the areas of Social Medicine is amazing.
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Tuberculosis clinic in Hopital Bon Samaritain (2019 CC BY-SA 4.0 Luis Falcon)

The kids at the HPS orphanage receive education, health and psychological support, as well as food and accommodation throughout the year. It was great sharing time, breakfast, lunch and dinner with them !
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Michel and team from Bon Samaritain Hospital in Limbé, Haiti

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Drawing by child at HBS orphanage (2019 CC BY-SA 4.0 Luis Falcon)

We also got to visit other health institutions in the area interested in implementing GNU Health.
The world can not turn its back on Haiti
Yes. Today Haiti is a impoverish country with civil unrest, and the world is turning the back on Haiti. Haiti exists and we must cooperate with its brave men and women of to bring back dignity to that beautiful country.
lady-cape-haitien-1

Lady in Cape Haitian . (2019 CC BY-SA 4.0 Luis Falcon)

Since the moment I put a foot in Cape Haitien, I felt the warmth of their people. Their noble smile and their genuine gestures of hospitality from Michel, his mom and the rest of the Haitian colleagues.
Michel is an example of resilience. Not only he is a great computer engineer, but he represents commitment and congruence. He decided to stay in Haiti, and fight for the much needed freedom, prosperity and peace in his country.
I am honored to have Michel Pierre as our GNU Health ambassador in Haiti, and looking forward to many implementations in the country. It has been an experience that I cannot describe with words. You must see for yourself to understand the situation in Haiti.
And yes, I agree with Sir Hilary Beckles, we, the rest of the World are in debt with Haiti. Is now our time to cooperate with our Haitians brothers and sisters, when they need us most.
References / Further reading:

Del software libre a la medicina social: la propuesta de un doctor canario para humanizar la sanidad

Disfruté mucho la entrevista de Natalia Vargas en Canarias Ahora.

Hablamos de la situación de la salud pública en España, del impacto de los determinantes socioeconómicos en la salud de cada individuo y del rol del software libre en salud, entre otros temas.

Niños de una escuela de Camerún

La adopción de GNU Health en muchas instituciones de salud en el mundo nos permite ser optimistas para que la Salud Pública, y la administración pública en general, adopte el Software Libre como forma de empoderamiento y soberanía tecnológica.

Enlace al artículo:

Del software libre a la medicina social: la propuesta de un doctor canario para humanizar la sanidad

https://www.eldiario.es/canariasahora/sociedad/software-medicina-propuesta-canario-humanizar_0_885411773.html

 

AIIMS adopts GNU Health

A new chapter in Public Health begins. The largest public hospital in Asia, and leading research institution has adopted GNU Health.
Group picture of AIIMS IT personnel and Luis Falcon
It has been a pleasure to meet in person the IT director Dr. Shariff and the rest of the team, that made me feel at home during my visit to the AIIMS in Delhi.
AIIMS is the largest public health institution in India and in all Asia.
During my stay, we had time to visit the facility, the infrastructure and give an initial training to the local team. The GNU Health implementation will be lead by them, and I am very happy to see that. Building local capacity is key for a large project like this.
GNU Health Federation - HMIS node
Thank you All India Institute of Medical Sciences for choosing Freedom and equity in healthcare !
AIIMS-memento-luis_falcon
I will always remember Dr. Shariff email on Febraury 2018. That mail started all. Thank you, and your team, for choosing GNU Health. Thank you for your hospitality in India, for  making me feel at home during my stay, and for all the beautiful presents I will always keep.
aiims_presents_gnu_health
The world needs more Social Medicine, and AIIMS has given another huge step forward in that direction.  We wish AIIMS all the best and, for now, we  give you a warm welcome our international GH Community !

Sanidad del siglo XXI en el Camerún rural

Artículo interesante de El País – Planeta Futuro – que habla de la informatización de centros de salud de Camerún.

En este caso, hablamos del caso del centro de salud de Bikop, liderado por la Doctora Ana Gutierrez y del centro de salud en Kribi, gestionado por Insoláfrica.

gnuhealth_at_bikop

GNU Health es, ante todo,  un proyecto social y me enorgullece ser parte de estos proyectos y poder brindar equidad en salud en el corazón de África.

Artículo fuente:

https://elpais.com/elpais/2017/10/31/planeta_futuro/1509473092_530414.html

GNU Health : www.gnuhealth.org

Twitter : @gnuhealth

El Software Libre no se mancha

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Existen dos tipos de miserables: las personas que sufren la miseria y aquellas que la generan.
La concentración del poder en el actual modelo socio-económico es tan injusta como insostenible. La privatización de la Salud Pública pervierte el derecho a una vida digna. La brecha social se profundiza, con ricos más ricos y pobres más pobres.
La codicia y el cortoplacismo del sistema están destruyendo la sociedad y el planeta. La contaminación medioambiental, la galopante deforestación y las granjas industriales son responsables del cambio climático que amenaza a las próximas generaciones.
Millones de animales son privados de su libertad y condenados al holocausto. Bebés arrancados del lecho materno destinados al matadero o encarcelados de por vida en mega granjas industriales en condiciones deplorables. Especismo y antropocentrismo inútil y despiadado, responsable de enfermedades cardiovasculares, cáncer, resistencia antibiótica y cambio climático.
Las corporaciones y sus gobiernos han encontrado herramientas formidables para el adoctrinamiento y vigilancia de masas. Similar a los medios de comunicación tradicionales, pero con métodos de control mucho más sofisticados que anestesian, hipnotizan y anulan el pensamiento crítico de los individuos.
Es imperativo retomar el control de nuestra libertad y dignidad, como individuos y como sociedad. La educación y el activismo social son clave para restaurarlos, y el Software Libre nos ofrece una magnífica vía para llevarlo a cabo.

El Software Libre representa lo contrario al modelo neoliberal. Entre sus fines está desarrollar comunidades, generar conocimiento y compartir recursos. Pero si queremos tener éxito, debemos afrontar y abrir un espacio para la discusión sobre las amenazas y riesgos existentes dentro y fuera de la comunidad.

En los últimos años hay un intento de desprestigiar el movimiento de Software Libre, principalmente por dos actores: La corporación del software propietario y núcleos de desarrolladores sin ética. Que la corporación y el software propietario intente dañar al Software Libre está dentro de lo esperado. Lo que requiere especial atención es el efecto deletéreo ocasionado por especuladores inescrupulosos infiltrados en la comunidad. El factor común de ambos actores es una lectura egoísta y retorcida de la libertad.
Según Richard Stallman, para que un proyecto sea Software Libre debe cumplir las cuatro libertades. Libertad para usar, estudiar, distribuir y mejorar el código. Estas “cuatro libertades” invitan a la colaboración y a construir comunidades alrededor del proyecto.
En el Software libre prevalece el sentido de libertad colectiva . La esfera colectiva tiene prioridad sobre la esfera individual. Por supuesto, el escenario ideal es que ambas libertades coexistan y se retroalimenten. Cuando la libertad individual coarta o anula la libertad colectiva, entonces no es Software Libre, aunque cumpla las cuatro libertades.

La laxitud del Software Libre está concebida para potenciar el espíritu comunitario y colaborativo. Desgraciadamente, esta flexibilidad ha permitido que se infiltren individuos y empresas miserables. Estos impostores tienen por objetivo engañar y apresar a la comunidad con sus malévolos cantos de sirena (Stallman lo denomina “Free bait” o “el anzuelo de lalibertad”).

Por ejemplo, hay quienes que, con nocturnidad y alevosía, sin previo aviso ni argumentos, se apropian, copian o bifurcan un proyecto de software libre activo. No han roto ninguna de las cuatro libertades, pero sus acciones los convierten en unos miserables que perjudican y traicionan a la comunidad.
A esos individuos les pido que mantengan sus sucias manos fuera de la comunidad, porque el Software Libre no se mancha.
La filosofía del Software Libre tiene mucho más de Libre que de Software. Cuando pensemos sobre Software Libre, pensemos en Software que ofrece Libertad. El software sólo es el medio para alcanzar la libertad.
En lo personal, adopté la filosofía del Software Libre como estudiante de ingeniería informática a principio de los años noventa. Actualmente, pasados veinticinco años, el Software Libre me ha permitido participar en muchos proyectos sociales y concretar principios de Medicina Social en instituciones de salud alrededor del mundo con el proyecto GNU Health.
Necesitamos avanzar, y para ello es fundamental que losgobiernos, organizaciones multilaterales y ONGs adopten el Software Libre. Las administraciones públicas que usan software privativo entran en una contradicción. Un bien público nuncapuede estar en manos privadas. Pidamos a los partidos políticos que incluyan el Software Libre en la administración pública, y podremos ver su compromiso social.
El Software Libre enseña, sana y hacepueblos soberanos. Permite generar un modelo económico sostenible, donde personas y empresas pueden colaborar con sus servicios, generando un medio digno y ético de vida. Hoy no hay ningún motivo para usar software privativo.
Cada línea de Software Libre codifica comunidad, democracia y dignidad. Codifica justicia social y un futuro mejor para las próximas generaciones y nuestro planeta.
Es tu elección.

Programa Encuentro Gran Canaria Solidaria 2017

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Un año más GNU Solidario estará presente en el Encuentro Gran Canaria Solidaria 2017, organizado por la Consejería de Solidaridad Internacional.
Los esperamos el día 19 de octubre en el Parque San Telmo de Las Palmas de Gran Canaria, no se lo pierdan !