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*preroll music*

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Herald: Our next speaker is Tarek Loubani.

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He is an emergency physician,

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working in the Gaza Strip and in Canada

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and he is developing medical hardware devices.

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And he is going to tell us about the 
Palestinian use of free hardware and software.

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So enjoy and give a warm welcome to Tarek.

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*applause*

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Tarek: ... (missing Audio)

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Thank you to CCC for inviting me 
to give this talk

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and to you for being here tonight.

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I want to start with just some very basic information
here about myself.

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If we can get the video feed up.

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OK, so there we go.

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If you want to get a hold of me, you can find me,
find this project on github,

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you can find our team on openmed at freenode,

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or you can always get a hold of me by e-mail,

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hopefully one of the easiest e-mails
you'll ever have to remember.

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And I'll bring that information up at the end.

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I want to start then with a story:

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This is another story, because you heard so many
about refugees.

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But this story is a personal one,

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because it is my story as a refugee.

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And about the time, that my father reminded me
of who I was.

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He put this card in front of me, 
when I was 8 years old.

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This card was literally the only thing,

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that atested to my existence as a human being 
for the first 12 years of my life.

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It says: The director general affirms that
Tarek Loubani is a palestinian.

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And as proof, I have given him 
this identity card.

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Not a lot to work, not a lot to own,
not a lot to do anything. That was it.

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And so I sat in front of my father,

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I just got, I think it was a C
on some meaningless subject

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as an 8 year old. Who cares?

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But he cared. He put that paper in front of me
and he said:

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Son, this paper, it doesn't prove 
that you're somebody,

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it proves, that you're nobody,

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that you're nothing.

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And there we were, living in Kuwait with 
a nice appartment that we had rented

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A and a car outfront. And he said:

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all of these things didn't belong to us and
could be taken in a moment.

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He had only one caveat to this nihilism.
He said:

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There is only one thing you have, one thing
that the wolfs can never take away from you.

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One thing, that you can never be dispossessed of.

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And that's what you know, 
that's the information in your head.

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That's what's up in here.

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And so was thesapokalyptic warning would 
result in me and my family minus my father

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because he was trapped in Kuwait at the time
driving through this:

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The highway of death 
as it would later be called.

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With my mother crying tears for weeks
while she got us out,

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her 4 children until we finally made our way 
through, I think it was 4 or 5 different countries

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and into Canada.

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Mine is a microcosmic lesson of the lesson,
that all Palestinian were given.

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Because all Palestinian have been dispossessed
at some point or will be.

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What do you think the parents of these 
children will tell them

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about who they are and what they possess?

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What do you think is the meaning of their homes
and physical possessions?

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What is it that they own or that they have?

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Their parents will tell them, 
what my parents told me:

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You have nothing and you are nothing.
Only what's in here.

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And so, if they are in their predatory drones
then we must be the prey.

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And that means, that we'll always live in the 
third world a different life

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from the life the people live in the developed 
world.

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You have to be on one of the two sides of
that predator drone of that advanced missle,

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of that technology, that litigation of 
treaty.

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And we had seen the light of the first world
from that those refugees camps.

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We saw it. And what we wanted was not
the Playstation 4s and the iPhones

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though yes, of course. Great stuff.

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What we wanted was the CT scanners

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and the hospitals that were outfitted so that
you could feel like you cold go in them

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and come a whole human being still 
just like you went in.

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That is the wealth that we wanted. That is the
wealth that we saw and that is the wealth

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that they protected.

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Both metaphorically and literally

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through all manner of instruments of 
neoliberalism and colonialism.

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They do it

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because to them everything, everything 
they see, everything in the world around them

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is fish.

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They can't see the world any other way.

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And so they think, that if you catch a fish
I can't have that same fish.

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And they don't realise, that we live in a 
different world, where not everything is fish.

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Where there is information
and that information can go anywhere,

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and be anything and it can help everybody
at the same time.

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It's not a new concept.

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It's a concept that was almost perfected
by Magritte, 85 years ago

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represented here:

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That is not a pipe.

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It is the information to make a pipe.

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That is not an STL. Or that is not a
reproduction, that is an STL.

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Let's put some economic terms on this,
because the people, who we are working against,

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the people who promote the anti commons
they put language on this stuff.

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This is the main language.

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We can divide it into two main axes:
excludable and rivalrous.

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All items more or less fall into these categories.

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And so fish falls into this category. It is a 
non-excludable, largely commodity

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that is rivalrous. Indeed

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it is very hard to keep people from 
catching fish out in the harbour.

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But if one person catches one fish, then
the next person can not.

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Where society wants us to be by and large is right here:

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Products that are non-rivalrous but excludable.

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Think for example of an mp3. An mp3 should be this:
public good, it is not excludable,

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you can't keep people from it.
It is non-rivalrous.

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You give somebody an mp3, you haven't 
taken away an mp3 from anybody else.

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And yet, what is desired, is for everything
to be here:

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A club good.

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You need a membership.

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Be that the country you live in or
the amount of money that you make.

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It is excludable.
Because they have excluded you.

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Not because of any inaid or inherant reason.

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How can we turn things from club goods
into public goods or

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another question: how have they turned things
from public goods into club goods?

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Well, here two men who've led the charge:

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Birch Bayh and Bob Dole.

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They came up with this legislation, that
ended up, basically making it so, that

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one thing that was available, non-excludable 
and non-rivalrous, that is

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all of the information coming out of universities
and these sorts of charities and other little groups

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could now be patented. Patenting is the 
main weapon here.

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That's how you turn things from usable by
everybody, available to everybody

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to usable by a few and available to few.

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Their policy was absolutely a success.

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Here you see the patents, starting from 1963
all the way to 2014. Total patents granted.

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1980 is highlighted in blue. Everything before
that is basically since the time of a man

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named Vannevar Bush,
who kind of floated the main idea,

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that information should kind of be out for folks.

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And as you can see, it's relatively stable.

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More or less minor deviations
more or less the same.

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But from 1980 to 2014 it virtually looks exponential.

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So closer with the numbers.

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1980 66 thousend patents, in 2014 326033.

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And so these weapons, they've resulted in 
us not being able to take things from

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simple idea to something we can use,
but instead we are loaded,

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we have to walk through these landmines.

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Now, this is a story that you all already know.

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Because it doesn't matter what country 
you live in.

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I'm guessing that everybody here lives in
first world.

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These are issues, that innovators in the first world
must content with.

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But by and large these are issues that stop
people in the first world from becoming rich.

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In the third world these are issues,
that can mean the difference between

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life and death.

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*applause*

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Here is an example from the late 90s
early 2000s.

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Profiteering pharmaceutical companies versus
South Africa.

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South Africa was in the middle of a 
absolutely terrible crisis,

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which arguable they have not exited
with HIV AIDS

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and pharmaceutical companies using
the weapon of patents

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were saying: ehm, sorry, we can not give you
this medication at the rate you can affort,

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we can not give this medication to everybody,
because what protects our profits?

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Now, most people aren't that crass most of the
time, there are not saying what protects our profits,

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because that's bad public relations.

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But they say: Oh, what about our research and
development funds etc etc.

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Of course mostly done on the public dime.

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But in the end every once in a while, we happen to
see, one of the type, who pops up, who speaks

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a little bit more from the heart, as we have seen
recently.

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What my father told me initially, was what I've been
taught for all the years of my life.

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*music*

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What he told me is that either
you are one of the predators

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or one of the prey.

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It is an absolutely irrefutable truth.

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It's a natural order.

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It is absolut. God gave us this.

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You have to be on one side or the other.

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You just have to accept it.

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*music of video still playing*

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And so if you're born the caribou, 
you have to own that existence,

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and just accept it.

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Well, just before I got on my plane here.
I was at work as a doctor.

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When I went to my shift, I did not go there,

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so that I would allow the natural order 
to take its course.

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I did not wake up today, so that the natural
order would take its course.

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Fuck the natural order.

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And fuck the world's who are behind it.

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I don't want it.

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People in Palestine don't want it.

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My patience don't want it.

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None of us want it.

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So, why do we accept it?

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If we look at the world around us

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what we're seeing then, is this thing, that 
we want to just throw off that natural order.

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But the terms of our insurgency have to be

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careful.

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You can't as the caribou look at the wolf and say:

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ehm, well, I don't really care, you know, 
fuck you and fuck your natural order

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and I am not participating.

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You have to be careful,

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because they are potent, they are dangerous.

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In this particular case the main danger
to us in the third world and developing nations

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is treaties.

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These laws are applied on us by treaty and 
you can't just opt out.

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The Palestinian economic system is shut down
by FIAT

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Medication can't arrive by FIAT.

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All of these things happen, because we are too
weak.

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And so, how do you respond?

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What is the tool of resistance?

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We eluded to it earlier.

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My father even told it to me as a child.

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Knowledge

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and the Commons

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That is where a better future comes from.

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And that is where our examples live.

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So let's think about the free software movement.
Let's look at some examples.

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Some of you are German. 
Munich is one such example.

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Munich has shifted allmost all of their city
digital infrastructure into free and open source.

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They even have their own Linux distribution.

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That's pretty amazing actually.

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There are other examples, that are some minor
cities here and there.

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There are some state wide examples.

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For example, such as Kerala in India.

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The chief minister basically like the prime, the 
highest person within Kerala at the time said:

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We believe that free and open-source software
is an essential component in our drive to

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democratise information technology and bring
its benefits to all sections of society.

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In additon to Kerala, Tamil Nadu has done 
something similar, also in India.

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And then there are some partial ministry level
efforts, that have been happening,

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for example Italy, in their ministry of, I think it is, 
defense or interior, you know, had decided

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just a small move to go from Microsoft Office
to Libre Office.

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Apperently small moves, but really
meaningful to the people around us.

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We'll look at this from places like
Palestine, like the Gaza Strip, where I work,

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and we think, why can't we do that?

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Why can't we participate in these commons?

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What is it, that we can do to contribute?

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At the national level, there are a couple of very
potent examples.

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The two main examples, that I ran into, 
were Equador and Brazil.

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Equador, if you guys were at the talk yesterday
is a very interesting and nuanced place.

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So there are some authoritarian tendencies.

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Bethany Horne, who I believe is in our 
audiency here, I won't point her out,

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is one person, who's been visited by the 
authoritarianism of the group.

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But notwithstanding, they are doing some very 
good things and one of those very good things

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is free software at the national level.
That's actually quite incredible.

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Directed from the presidency.

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Brazil very similar. Brazil started their move
almost the same time, maybe a little bit before.

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So, Palestine looks quite ripe. For exactly the 
same thing we've been seen,

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has a few characteristics:

231
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These are the literacy levels of 
a few different countries.

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United States and Germany,
basically 1% who are illiterate.

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Brazil and Equador 90.4 and 91.6

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Palestine 95.3. That's the Westbank and the
Gaza Strip. My best guess, if you would include

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the diaspora that number would go significantly up.

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Because the diaspora tends to be well educated.

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That means that this lesson 
that my father gave me is a lesson that

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clearly Palestinians have been receiving for
years if not decades.

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They're intelligent people, they're well educated.

240
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They're living under occupation and they want to
see a change.

241
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So, we've started all of the same things 
that you would expect.

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We started of course replacing all of our servers 
with Apache based

243
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if any of them were ever on Windows.

244
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We've started of course using backends for 
our contact management systems, like

245
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Joomla and Drupal.

246
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Of course, we started doing those things.

247
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In terms of the infrastructure that's more or less
the step where we are.

248
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We are at infrastructural components rather
then desktops.

249
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We have a very nascent EMR, 
that will be coming up hopefully soon.

250
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And we expect that this EMR will leverage at the
best of what we have and what we see.

251
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However there is something else that's interessing
a response to the necessity we have in Palestine.

252
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We learned that lesson from people, decorating
their shoes, submerging their computers

253
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from Novenas and homemade 
chicken CT scanners.

254
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And what we started doing is making our 
own hardware as well.

255
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I believe that the Gaza Strip is the first place
that is trying a national level strategy for

256
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open source hardware and is pushing it hard.

257
00:21:19,823 --> 00:21:28,787
We saw 3D printers, we saw how they worked.
We wanted our own and we got them.

258
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Leftmost is the very first 3D printer ever
made in Gaza.

259
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In the middle and the next one are their children.
Made entirely in Gaza.

260
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Some of the electronics have to come in,
all of the motors are salvaged from garbage.

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We expect that within a year, we'll be able to
make everything domestically.

262
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That's our hope and that's our dream and
I think we can get there.

263
00:21:51,478 --> 00:21:55,225
Of course my own work has been to make 
medical devices.

264
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That's where I've been leveraging them.

265
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This is a stethoscope, a very early version.

266
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This is the final version as of 3 weeks ago
approved by Health Canada.

267
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This is a first world medical device, 
that is available for pennies.

268
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*applause*

269
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2 Dollars and 50 Cents to replace 
a 300 Dollar stethoscope.

270
00:22:21,277 --> 00:22:25,321
It's not that people have 300 Dollar stethoscope
running around, I said they had nothing.

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Now they have something.

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It's been with the help of Kliment, who you will
recognise from around here and

273
00:22:31,055 --> 00:22:32,933
Jenn who you will recognise from here

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00:22:32,933 --> 00:22:39,568
and some engineers, who I can't really show,
because I fear for their safety.

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Our Palestinians, the heros, 
the real heros of this work.

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And as you can see here from a frequency-audio
response curve, it's as good as anything out there.

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We're working next on a pulse oximeter with the
help of really talented engineer Hanan Anis

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from University of Ottawa. And that should be 
ready by the middle of next year.

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Surgical tools will be forthcoming, because
right now in Gaza we're washing everything

280
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with salt water.

281
00:23:08,110 --> 00:23:15,799
And prostetics are coming, we hope.
Lots of issues there, but not technical.

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We have this origin story for the commons, as 
so the commons was something from the past.

283
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That was there and then now it's gone.

284
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But that origin story, I think, is a myth.

285
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And when we recognise, that the commons
are actually an evolution of where we are

286
00:23:34,440 --> 00:23:38,125
rather than somewhere that we were before,
we trying to reclaim.

287
00:23:38,125 --> 00:23:43,451
Then I think the next step is trying to
figure out, how to get back there.

288
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At that's what we are trying to do in Palestine.
How do we get back there?

289
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The biggest way is to break down those borders
and blockades and share information.

290
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And so, I want to invite you, all of you
to come with me to Gaza

291
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In May for the first international Free and 
Open Source Health Conference.

292
00:24:11,814 --> 00:24:18,388
Where we will discuss these ideas
and where we will try to move forward

293
00:24:18,388 --> 00:24:22,623
the commons. If the anti commons
is generally funded by

294
00:24:22,623 --> 00:24:26,954
military industrial complex, as we see within
Silicon Valley and so on,

295
00:24:26,954 --> 00:24:31,972
then maybe this commons can be funded
by the ever green spending

296
00:24:31,972 --> 00:24:35,514
that we always have in health care.

297
00:24:35,514 --> 00:24:40,088
Health care is one of the biggest spends
in the Gaza Strip.

298
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And if we direct it in the right places we can also 
use it to develop our national sovereignty.

299
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Join me, in whatever where you can.

300
00:24:53,090 --> 00:24:56,601
And let's make it more sovereign
better place.

301
00:24:56,601 --> 00:24:58,800
For Gaza and for everywhere else.

302
00:24:58,800 --> 00:25:00,282
Thank you.

303
00:25:00,282 --> 00:25:12,117
*applause*

304
00:25:12,117 --> 00:25:18,874
Herald: Thank you for the talk.
And we have about 5 min for questions.

305
00:25:18,874 --> 00:25:27,124
So please if you have any questions line up 
in front of one of the microphones.

306
00:25:31,866 --> 00:25:33,488
Please!

307
00:25:33,488 --> 00:25:40,838
Question: I would like to know, how did you 
distribute your open source instruments.

308
00:25:40,838 --> 00:25:47,886
Is it also possible for other countries that have
the same problems as in Palestinian areas

309
00:25:47,886 --> 00:25:49,595
to get those?

310
00:25:49,595 --> 00:25:55,409
Tarek: Yes, absolutely. One thing we don't do
is give medical devices.

311
00:25:55,409 --> 00:25:59,989
Anybody who's interested, and there have been
few ministry to ministry contacts on this,

312
00:25:59,989 --> 00:26:05,219
is basically encouraged to start up their own
fundamentally fab lab.

313
00:26:05,219 --> 00:26:11,713
So, what we do is, we go into a country, talk to their
engineers, engineering departments and so on,

314
00:26:11,713 --> 00:26:17,341
and we try to get them up and running, 
so that they're manufacturing their own stuff.

315
00:26:17,341 --> 00:26:24,207
This means anybody who's tried to start an open
source project or free and open source project

316
00:26:24,207 --> 00:26:26,735
will know that the more contributors the better.

317
00:26:26,735 --> 00:26:28,266
You don't want consumers.

318
00:26:28,266 --> 00:26:30,428
You want people, who are participating.

319
00:26:30,428 --> 00:26:35,675
And so anybody who wants to... it's under an open
source licence. The open hardware licence.

320
00:26:35,675 --> 00:26:39,800
And actually it's also cross licenced to GPLv3.

321
00:26:39,800 --> 00:26:45,390
Please take it. It would be my privilege to see it 
in the news everywhere else. It really would be.

322
00:26:45,390 --> 00:26:50,675
Everybody who's working on it, wants to see that.

323
00:26:55,515 --> 00:27:01,948
Herald: OK, thank you very much again and see
you at the next talk, enjoy the rest of the conference.

324
00:27:01,948 --> 00:27:06,351
Oh, wait we have a question from the internet
it seems.

325
00:27:06,351 --> 00:27:11,313
Question: What would be the solution to Palestine?

326
00:27:15,063 --> 00:27:20,411
Tarek: I don't think you need to worry about the
occupation. I think that's the question.

327
00:27:20,411 --> 00:27:23,471
Don't worry about the occupation.

328
00:27:23,471 --> 00:27:26,891
The occupation is a little bit like a marathon.

329
00:27:26,891 --> 00:27:30,696
You have to keep working, we see the end though.

330
00:27:30,696 --> 00:27:33,874
The Palestinian will take care of their own freedom.

331
00:27:33,874 --> 00:27:35,569
You don't need to worry about that one.

332
00:27:35,569 --> 00:27:41,449
All you need to do as much as possible,
is try to not participate within the occupation.

333
00:27:41,449 --> 00:27:47,291
Now, I travel through Israel and nobody, who 
travels through Israel is allowed to endorse

334
00:27:47,291 --> 00:27:52,928
the boycott divestment and sanctions campaign,
because that would be illegal and would mean

335
00:27:52,928 --> 00:27:54,614
I could not travel through Israel.

336
00:27:54,614 --> 00:27:58,572
However some people consider it to be a
nonviolent way of participating against

337
00:27:58,572 --> 00:28:01,736
the occupation.

338
00:28:01,736 --> 00:28:06,942
Now, what we do need to do is figure out
what happens the day after occupation

339
00:28:06,942 --> 00:28:15,887
that's what worries me. For example there is
a Coca Cola bottling company being built

340
00:28:15,887 --> 00:28:22,288
in the Gaza Strip. Why? It's going to use more
water than the entire Gaza Strip has available to it.

341
00:28:22,288 --> 00:28:27,200
More concrete than in all of the construction
projects. Why?

342
00:28:27,200 --> 00:28:30,722
Because they are looking for the day after
occupation.

343
00:28:30,722 --> 00:28:34,911
And what I don't want is for Palestine to turn
into South Africa.

344
00:28:34,911 --> 00:28:41,923
Beautiful dreams, excellent vision and you 
loose the war the day after the occupation ends.

345
00:28:41,923 --> 00:28:45,510
That's why we have to encourage
these democratic institutions.

346
00:28:45,510 --> 00:28:50,612
That's why we have to participate in these, I guess
essentually like chaos based

347
00:28:50,612 --> 00:28:55,696
anarchist based collectives, that are going to move
forward the democratic process there

348
00:28:55,696 --> 00:28:59,509
and everywhere else.

349
00:28:59,509 --> 00:29:05,409
*applause*

350
00:29:05,409 --> 00:29:11,149
Herald: So we have time for one final question.
The microphone at the right please.

351
00:29:11,149 --> 00:29:16,374
Question: The big one. Can you say something 
about the interface between open medical devices

352
00:29:16,374 --> 00:29:23,090
and regulation? So in Europe most of the stuff is
public or a lot of it is public, so you have two layers

353
00:29:23,090 --> 00:29:27,649
of regulation: one is what devices you're authorised
to use and operating on the human body.

354
00:29:27,649 --> 00:29:31,848
The other one is how you're authorised
to buy the stuff,

355
00:29:31,848 --> 00:29:35,617
so procurement regulation is very, very rigid
in some European countries

356
00:29:35,617 --> 00:29:41,032
in term of medical devices. Most of the stuff
would be illegal.

357
00:29:41,032 --> 00:29:46,169
Tarek: It was very important for us, the project
wasn't, you know, people have made stethoscopes

358
00:29:46,169 --> 00:29:51,115
and actually a lot of people told me this. They
said, your's isn't the first 3D printed stethoscope.

359
00:29:51,115 --> 00:29:53,622
I made one, we made one, whatever it is.

360
00:29:53,622 --> 00:29:57,460
And it is true, we are not nearly the first
3D printed stethoscope.

361
00:29:57,460 --> 00:30:05,282
We are the first validated and now Health Canada
approved 3D printed stethoscope.

362
00:30:05,282 --> 00:30:13,183
I think that these regulations are actually
a good thing, because the population is

363
00:30:13,183 --> 00:30:16,575
an incredibly vulnerable population 
on the other side.

364
00:30:16,575 --> 00:30:20,701
We see a lots of experiments being run on poor,
disenfranchised people.

365
00:30:20,701 --> 00:30:23,154
It happens in the first world.
Think Tuskegee and

366
00:30:23,154 --> 00:30:25,750
similar things are happening today.

367
00:30:25,750 --> 00:30:31,796
It happens in the third world,
think Nestle and such projects.

368
00:30:31,796 --> 00:30:34,825
So I think the regulations are a good thing.

369
00:30:34,825 --> 00:30:39,363
The FDA, you know, probably not. It's very 
expensive, very hard to get through.

370
00:30:39,363 --> 00:30:44,907
But it's not taxing to get through
reasonable regulatory bodies, like Health Canada.

371
00:30:44,907 --> 00:30:51,099
I myself don't object. What I see in the Gaza Strip
is people there want to know

372
00:30:51,099 --> 00:30:55,513
that they're not receiving garbage. So they're
asking for these regulatory approvals.

373
00:30:55,513 --> 00:31:01,961
The Gaza Strip will not use expired medical
devices, that people, you know well-wishers and

374
00:31:01,961 --> 00:31:06,962
some hospital in the first world that decided
I like rather throw this away in the Gaza Strip

375
00:31:06,962 --> 00:31:10,443
than throw this away in the garbage.
No we don't want that.

376
00:31:10,443 --> 00:31:15,627
There is a dignity as well that has to be provided.
And that dignity comes with the same standards

377
00:31:15,627 --> 00:31:20,786
being met in the third world as in the first world

378
00:31:20,786 --> 00:31:26,538
Herald: OK, thank you very much. Unfortunately
we are out of time, but I hope you enjoy the

379
00:31:26,538 --> 00:31:29,565
rest of the congress and see you at the next talk.

380
00:31:29,565 --> 00:31:38,249
*postroll music*