Preface[edit | edit source]
Regardless of the remarkable achievements in technology, thousands of children will die today from preventable diseases. Infectious diseases such as malaria, chagas, AIDS, tuberculosis or infectious diarrhea destroy millions of families in developing countries. Noncommunicable diseases including obesity, diabetes, heart disease, cancer or major depressive syndrome hit both the North and the South Hemispheres, although with much higher prevalence and incidence among the underprivileged sectors. Equally important are the alarming levels of child labor, human trafficking and sex slavery, family violence, child abuse or drug addiction. Complex, multi-etiological and anthropological issues also exist that desperately need to be addressed.
We need a change of paradigm: We need to move away from the reactive Model of Disease, to the proactive Model of Health. Many countries lack good public health, sometimes because they put the focus on the private sector; sometimes because they give too much emphasis to technology. The most sophisticated technology will never beat good Primary Health Care policies. Education, good nutrition, family affection, physical exercise, and sanitary housing conditions are the best and most sustainable public policies one can make. The concept of Integrative Medicine is always present in GNU Health.
I started the GNU Health project in 2008 to improve Primary Health Care (PHC) in rural communities. Today GNU Health has grown to a full Health and Hospital Information System, but the spirit remains the same. GNU Health complements PHC, but never will replace the work of the mother, teacher, nurse, doctor or social worker. What GNU Health does well is handling and processing large amounts of data. GNU Health manages demographics; patient evaluations, hospitalizations, clinical history; genetic and hereditary risks; epidemiology and health center resources (stock, finances, human resources, pharmacies, laboratory .. ), to name a few resources. Computing power and data processing improve team work and optimize health promotion and disease prevention campaigns. For example, GNU Health allows quick identification of new TBC or Dengue outbreaks by showing the index cases in a map, in real-time. It can show the trends in infestation level of vectors that transmit Chagas disease in Domiciliary Units; It can cross indicators in different communities, and relate Social determinants of Health in many conditions (family violence, teenage pregnancy, child mortality, ... ).
In 2018 we have made 10 years since our initial release. We are now a mature ecosystem, with a mature community. GNU Health now incorporates state-of-the-art technology in bioinformatics, genetics and proteomics. GNU Health brings Precision Medicine, always in the context of the person and patient, providing a holistic picture of the person that we have in front, from the biological and molecular basis of health and disease, to the socioeconomic determinants of health. The GNU Health Federation introduced in 3.4 series allows to build nationwide federated networks with thousands of heterogeneous nodes. The GNU Health federation is revolutionary, and will allow the community, the health practitioners, the research institutions and the ministries of health to have much better perspective and precise information on the individuals and their context.
The GNU Health Book of Life, and the pages of life introduce a new, trans-disciplinary way of doing medicine. Our health is much more than just cold medical records. Most of the time, our health is the result of many events related to the environment, decisions we make, and interactions with many actors, that shape our life as individuals. The GNU Health pages of life put the person on the driver seat, making them an active actor of the system of health. It also provides the health professional a great way to enter and study the health determinant factors, especially in the context of the GNU Health Federation.
GNU Health is a philosophy. It's putting Free Software as a public good, and as an integral part of Public Health. It's about equity, community work and solidarity. It's about empowering the health professionals, their health centers and their communities. It's about putting in action many aspects from the Alma-Ata Declaration.
GNU Health is about embracing System of Health paradigm, instead of the conventional system of disease that many countries are immersed today.
I hope you enjoy this book, and I count on you to join our growing community of academic institutions, NGOs, public hospitals, private companies and Multilateral organizations. Free Software in Health Care is here to stay.
eHealth for all !
Luis Falcón, MD
Las Palmas de Gran Canaria, Spain