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Tag Archives: Libre Software

Quo vadis, Free Software?

25 Thursday Mar 2021

Posted by Luis Falcon in Libre Software

≈ Comments Off on Quo vadis, Free Software?

Tags

Free Software Foundation, fsf, Libre Software, RMS, Social Justice

In his escape from Rome, Peter encounters Jesus and asks him, Jesus, Quo vadis? (“where are you going?“) Jesus responded, “Back to Rome, to be crucified again”. Peter follows him, ends up being captured and crucified upside down.

(Painting: Domine quo vadis? (1602) by Annibale Carracci. Source Wikimedia)

Two thousand years have passed, yet those who defy the status quo are still being prosecuted and crucified, one way or another.

Too much hypocrisy and lack of empathy

The prosecution and public lynching that Richard Stallman, creator of the Free Software movement, has suffered in the last year and half is unparalleled. Many of those who used to praise his work and figure, are now taking the first row in the lapidation of the heretic.

Richard Stallman might not be the best in social interactions, but neither am I. Richard is not politically correct either. Some things he has said can be controversial and even disturbing. But that does not make him a criminal or a monster. In more than one occasion, I’ve noticed that I’ve misunderstood his words after talking to him or re-reading the article.

We all are imperfect beings, with imperfect genes, living in an imperfect society. We come from different cultural, social, educational and generational backgrounds. I find this enriching and fascinating. Yet, there is still too much hypocrisy and lack of empathy in our society.

Let me share a short personal story. In 2018 I was invited to give a talk at LibrePlanet. I flew from Spain to Boston, and I was excited to meet with the colleagues from the community, so I signed up to the “Welcome dinner”. To my surprise, I got this response by email upon arrival:

"The Welcome Dinner is for all women, gender queer, non-binary, and gender non-conforming people interested in free software. If you don't identify as such, we kindly request that you don't attend the dinner this year."

So I checked whether all the list elements, looking for latino, hispanic, vegan, …. but no luck… after a long haul flight, I found myself excluded from the event. Where is the diversity, where is the inclusion, where is the empathy? Ironically, I found out that the very same person who sent me the email excluding me from the dinner is now part of the debunking campaign against RMS.

Let he who is free of sin cast the first stone

Who are we to judge? On what moral grounds are they judging Richard Stallman?

Discrimination on the basis of species is as terrible as any other form of discrimination (sex, race, age..). Those who eat meat are complicit of the daily holocaust of millions of sentient beings. Those who drink milk are complicit of the systematic rape, slavery and murder of millions of persons who have the same right to live in freedom and dignity as we humans. In addition, non-vegans are responsible in the climate change emergency, pandemics and other terrible side effects of factory farming.

I am convinced that many of those who are judging RMS are meat eaters and consume dairy products. So, before they accuse him for something that he might have said, they should take a look at themselves and their ethical / moral status, for what they are actually doing. I also think that many of them would not have joined this evil campaign if they knew how much pain and suffering it has caused to Richard.

Divide and conquer. The attempt to eradicate the Free Software movement

The existing plutocracy controls de media and distorts reality. The panem et circenses formula works great in creating a numb, docile society. Their mass control devices and programs activate the dopaminergic reward pathways on the person brain, creating a short but intense feeling of instant gratification through selfies, filters, likes. You willingly provide them your personal information. They know where you are, they know what you do. They will also make a lot of money selling your information to others who will refine the mind control process. This becomes a closed loop.

They have gradually eradicated critical reasoning. Activism and social justice are now forbidden terms. “Free Software” is now “Open Source”. To be a cool programmer and a good citizen, you have to share your code “Where the world builds Software“. It’s a proprietary platform, but this fact would not make a difference to you anymore at this point. You have become part of them, and your principles about the initial Free Software movement have faded away.

After creating the “idyllic community”, it was time for them to find a common enemy. The witch-hunt started by debunking the creator of the Free Software movement and then anyone that would defy the status quo. Vilifying RMS on the news and social media was an easy task for them, provided that they control most of the media and that they already counted with an “army” ready to burn heretics. The army members did the dirty job for them, proudly posting on their timelines how they contributed to the ruthless public mobbing, lynching and lapidation of someone who most of them, didn’t even know. The rest is history.

Time to hit the reset button

No doubt that the Free Software Foundation and the movement of free software and free culture is badly injured. The enemies of social justice and freedom in our society have tried to eliminate the Free Software Foundation and divide the community.

Yet, we are strong and resilient. Let’s come together, reunite and return even stronger. Society is facing very challenging moments, and we need the Libre Software movement to be a reference of evolution, diversity, respect and inclusion. The enemies of freedom and equity want us divided, so they gain control. We can not let that happen again.

Let us all take some time for self-reflection, to get rid of any resentment. Let us find room for forgiveness to our fellow members of the Free Software movement and hit the reset button. Let us put aside the confrontation among us that will take us nowhere.

Let us also support financially the Libre Software community. Most Libre Software projects and organizations depend on the financial contributions, and they should be able to grow with the support of their individual members alone. That will bring independence from the corporation.

Our mission as individuals and members of the Libre Software movement goes way beyond programming. The code that we write in C or Python must also be the source of an optimistic message to this and upcoming generations around the world. A genuine and honest message of freedom, equity, compassion, empathy and solidarity.

Happy and healthy hacking!

GNU Health and Khadas to deliver Artificial Intelligence in Medicine

30 Wednesday Sep 2020

Posted by Luis Falcon in GNU Health, GNU solidario

≈ Comments Off on GNU Health and Khadas to deliver Artificial Intelligence in Medicine

Tags

Artificial Intelligence, big data, bioinformatics, genetics, genomics, GHCon, GHCon2020, GNU Health, GNU Health Federation, GNU solidario, Khadas, Libre Software

It is official: GNU Solidario, the Spanish NGO behind GNU Health (GH) and Khadas Technologies have signed the “GNU Health Alliance of Academic and Research Institutions”, to research and deliver Artificial Intelligence to the world of medicine.

This is very exciting. GNU Health covers genomics, medical genetics, Dx imaging and social medicine, areas where definitely we can use the power of AI for better diagnostics, personalized treatments, decision support, disease prevention and health promotion.

The GNU Health embedded project using Khadas for Artificial Intelligence in Medicine

What is truly revolutionary is that we will be using affordable single board computers, like the Khadas VIM3, where they could work alone or in the context of the GNU Health Federation, doing massive virtual parallel computing.

Citizens, health professionals and institutions don’t have to spend millions to access the latest in technology. In GNU Health, this has always been our philosophy. Health is must be remain a universal human right, and that is what we do in GNU Health. We deliver state-of-the-art technology all over the world with Libre Software. No hidden lines of code, no hidden agenda.

One of Khadas devices, the VIM3 includes a Neural Processing Unit (NPU) that will be the heart of the AI engine.

GNU Health HMIS with genetics package running on a Khadas VIM3 Pro

We can use our GH Federation model which gathers massive information of protein natural variants, and combine it with the latest tools in Artificial Intelligence. We will be giving a giant leap, unveiling the real clinical significance of many mutations that today remain a mystery about how they would affect our health. In GNU Health we are determine to build this critical bridge between the person, the clinician and the researcher.

Another area that we’ll work on is Dx imaging. Training Khadas devices to differentiate many types of lesions will help the pathologist or the surgeon to take real-time decisions in the operating room based on the picture GNU Health camera takes and the diagnostic that the GH embedded return about the specimen.

In the upcoming GNU Health Conference – GHCon2020– , there will be sessions about this project, so we invite anyone to register at the conference, that this year will be online due to the COVID pandemics. Register at GHCon2020

GHCon2020, the annual GNU Health conference

About GNU Solidario: GNU Solidario is a non-for-profit organization that works globally, focused on Social Medicine and health informatics (using Libre Software).

GNU Solidario is the organization behind GNU Health, the award
winning Libre Health and Hospital Information System, deployed in many
health and research institutions around the globe.

About Khadas: Khadas develops superior quality, high performance single board computers for makers, developers, and tinkerers, that come with open source, professional technical support, and a global community for issue discussion & idea sharing.

GNU Health: Helping Laos Heal from UXO physical and emotional trauma.

25 Saturday Jul 2020

Posted by Luis Falcon in GNU Health

≈ Comments Off on GNU Health: Helping Laos Heal from UXO physical and emotional trauma.

Tags

ehealth, GNU Health, GNU solidario, Laos, Libre Software, Public Health, Social Medicine, UXO

Luis Falcon with the Lao CMR staff in charge at the 2 year anniversary of the implementation
GNU Health implementation anniversary at Laos Center of Medical Rehabilitation

Laos is one of the most heavily bombed countries in the world. During the period from 1964-1973, over 2 million tons of bombs were dropped by B-52 aircrafts across the 2/3 of the country during the “Secret War”. This nine-year period bombing caused thousands of deaths and a unprecedented human displacement that exceeded a hundred thousand civilians from the poorest areas of the country.

The tragic legacy of that period remains today. Thirty percent (30%) of those bombs remains active (Unexploded Ordnances – UXOs – ), causing over 300 victims every year until 2008, and now down to 50 / year. Nearly 60% of the UXOs accidents result in death, and 40% of the victims are children[1].

If the explosion does not kill the person, it causes severe traumatic injuries resulting in the amputation of limbs in many of the victims. Physical and emotional trauma that takes many years to heal. In addition, many UXO victims suffer from Post-traumatic stress disorder (PTSD), a serious condition that can be devastating for the victim and their families[2].

But there is hope. The wonderful people from Laos are resilient, and they are willing to cope and move forward. I have been in Laos several times in the last few years, in the context of GNU Health implementations both in Mahosot Hospital and the Center for Medical Rehabilitation – CMR – .

The Center for Medical Rehabilitation (CMR), located in Vientiane, is a specialized institution that helps people with disabilities and victims survivors of UXOs. The CMR, formerly known as the National Rehabilitation Center initially provided prosthetic limbs for victims of war. Today they have extended the services to provide services to children with disabilities across the country. Some of the services include medical and community based rehabilitation, special education for the deaf and the blind and vocational school for people with disabilities.

At the moment I had the meeting with the hospital directors, I knew that we had to focus both in short term surgery as well as in the long term psychological, physiotherapy and occupational therapy that would allow the person to be fully functional in the society. Again, I was facing a project in need of Social Medicine.

We trained a local multidisciplinary team of nurses, doctors, physiotherapists, social workers, computer scientists, psychologists, administrative personnel, pharmacists and accountants.

CMR nurses. The heart of the institution

It was during that period that I created the package “functioning and disability“.

General patient information and Functioning & Disability tab. Red boxes on these two sections denote UXO related information

Some of the GNU Health functional modules that CMR decided to use included surgery, socio-economics, ICD-10, nursing, physical therapy, stock, accounting, lifestyle, reporting, health services and diagnostic imaging, among others. In addition to those, we included the “functioning and disability” package.

The GNU Health “Functioning and Disability” package integrates the ideas of WHO Health Organization International Classification of Functioning, Disability and Health. This functionality complements the ICD-10 classification of diseases, with the concept of functionality. For example, after a person has been diagnosed with diabetes, we must go beyond the biology and molecular bases of the disease, and evaluate how diabetes impacts of on her daily activities and integration in the society and environment.

GNU Health contextualizes the health condition in the particular individual, key for personalized medicine. In the UXOs example, the related ICD10 codes are visible from the main chart:

  • S88 : Traumatic amputation of lower limb
  • F43.1: Post-traumatic stress disorder

This diagnostic information is relevant and key for epidemiology and statistics, but if we want to practice medicine, we must take into account the social aspect of these conditions, and how they affect the person in her particular environment.

The GNU Health Functioning and disability assessment has two sections. The first section is a summary of impairments related to the Cognitive, Visual, Hearing, Speech, Hand, Mobility and Activities and Participation .

The second section is a detailed assessment of Body functions, Body structures, Activities and Participation and Environmental factors and barriers. Each of these groups has its own set of qualifiers and components that will provide the health professionals where to put the focus to the time and the context of that person, as well as to evaluate the progression of the conditions.

We can now study, with a multi-disciplinary team, how the body structure and body functioning impairments relate to the person capacities and engagements in social activities; daily household tasks; using the current public transportation system or the level of access to Labor and employment services.

This is my concept of medicine, the assessment of the bio, psycho, social determinants of health and disease. Medicine is, first and foremost, a social science, and GNU Health is first and foremost, a social project.

Example of GNU Health person functioning and disability assessment

Celebrating the success of cooperation: During a two-year period of using GNU Health, they have provided over 67,000 medical services, automated their finances, prescriptions, stock management, medical appointments and evaluations, diagnostic imaging, and the demographics tracking for the thousands of patients they assist.

CMR Cope team helping people in Lao rural areas

Local capacity building: CMR trained its own local group of professionals who customize and maintain GNU Health, in their own Lao language. This creates a local and ethical business model, very important for the long-term sustainability of the project.

A well-deserved award. The work that CMR has been doing in Laos for the rehabilitation of their people has been magnificent. Their multidisciplinary approach to trauma, from the acute care and surgery, to the physical therapy and the work in the field is an example for many of us. CMR has helped thousands of people every year healing from the UXO physical and emotional scars, moving forward and being able to get re-inserted in society, and we are so proud to have been part of it.

A delegation of the Laos Ministry of Health presented at GNU Health Con 2016 the implementation in the Lao Center for Medical Rehabilitation – CMR – and in Mahosot hospital. We are so proud that they are part of the GNU Health community.

CMR received the GNU Health Social Medicine Award in 2016 for best Institution.

  1. – Somnuk Vorasarn, Chansaly Phommavong, Khonephet Sely. GNU Health in Mahosot Hospital – GNU Health Con 2016
  2. A cross-sectional community study of post-traumatic stress disorder and social support in Lao People’s Democratic Republic

GNU Health in Tanzania. An implementation case.

26 Tuesday May 2020

Posted by Luis Falcon in GNU Health

≈ Comments Off on GNU Health in Tanzania. An implementation case.

Tags

Africa, GNU Health, Hospital Information System, Libre Software, SDG

The following note comes from Mike and Ulf, two Swedish colleagues that implemented GNU Health in Tanzania. The specific institution is Nkinga Hospital. Mike and Ulf have been part of the GH commuity for years. I met personally Mike at the GNUHealthCon 2019 in Brussels. Their work is phenomenal.

The title of his document was “How to Implement GNU Health in Tanzania in 10 days”. We’re very thankful to them for sharing this very inspiring story, and hope is a lesson to all of us!

Background

It all started with that we had studied free software and networks at universities in our spare time for a few years. When we had finished the studies we decided to do something with the knowledge we got. We got in contact with Nkinga hospital in Tanzania and we decided to help them to build the IT-infrastructure.
In September 2011, we went to Tanzania to build a computer network to be able and communicate internal and share documents in the hospital. We set up Wi-Fi points, installed servers and educated technicians.
In August 2014, we traveled to Nkinga to extend the network and set up a PACS server and computers for reviewing x-ray pictures.

Goal
Our goal with this project was to implement GNU Health at the hospital in short time.
The system consists of one server, one spare server, a backup server and about 30 workstations spread out at the hospital. The project also included training of the hospital’s users and to educate technicians to manage the system and network with our remote support.

Challenges
undefinedWe planned to introduce the system in 10 days and expected to start using some basic modules. When the basic modules worked, the plan was to continue implementing more modules . In order to manage to deploy the system at Nkinga in the short time, a medicine manager and an economist from the hospital visited us in Östersund for two weeks to prepare the implementation.


Implementation
When the two personnel went back to the hospital they arranged training sessions for different personnel groups and was a cornerstone for the implementation of the project.
During the first day of using GNU Health, it was discovered where it did not work as it should. For example, it became a bottleneck in the front desk where patients ensign themselves. In the first three days, in parallel with GNU Health, the hospital used paper. In the evening, the data on paper were
fed into the system.
Over the next few days, we moved around the hospital and instructed staff how to use the system. Not everyone was used to computer so it took some time. Everyone in the hospital has been very helpful and we worked up to 16 hours every day.

Afterword
In the first few days after we got home, the hospital contacted us daily about issues that arose and together we solved them. For every week that passed, the problems decreased. After 4 weeks of running GNU Health everything run smoothly. We have weekly telephone meeting to discuss
various issues. At the hospital they have worked very intensively with the training of staff and to optimize the flow. The understanding of the benefits of the hospital system is increasing all the time. The preparation of implementing GNU Health took us approximate one year.

Summary
Examples of work done during ten days:

  • Expanded computer network
  • Installed 25 new computers
  • Assembled and installed 3 servers
  • Training of users
  • Training of Technicians
  • Installed a number of routers and switches
  • During 10 days we (seven people) worked at total 820 hours .

For the implementation of GNU Health, we have purchased hardware for about 8000 EUR sponsored by an aid organization. We shipped 25 used computers and network equipment that we received from different companies.
After 2 months of using GNU Health, 2083 patients was enrolled in the system, 1873 appointments performed, 80 users worked in the system, 1600 invoices print, etc.

GNU Health has been running since November 2017 with only minor disturbance.

Pictures from Mike & Ulf blog (https://nkingahospital2017.wordpress.com/)

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