Now Bootstrapping · Open for Contributors

The Sovereign Digital Health
Operating Platform

A free, open-source, FHIR R5‑native platform that coordinates EMR, EHR, HIS, public health surveillance, and ERP into a single governed system — built for the last mile, designed to outlive any vendor.

Active in: 🇧🇩 🇮🇳 🇲🇲 🇵🇰 🇹🇭
FHIR R5 (5.0.0)·
Go 1.26 Backend·
SMART on FHIR 2.1·
ICD-11 · SNOMED CT · LOINC · CIEL·
PostgreSQL 18 JSONB·
Offline-First (Raspberry Pi 5)·
DHIS2 · OpenMRS · Go.Data · HL7 v2.9·
Apache 2.0 Open Source·
$0 Forever·
212 Repositories·
Flutter · Tauri · Next.js 15·
FHIR R5 (5.0.0)·
Go 1.26 Backend·
SMART on FHIR 2.1·
ICD-11 · SNOMED CT · LOINC · CIEL·
PostgreSQL 18 JSONB·
Offline-First (Raspberry Pi 5)·
DHIS2 · OpenMRS · Go.Data · HL7 v2.9·
Apache 2.0 Open Source·
$0 Forever·
212 Repositories·
Flutter · Tauri · Next.js 15·

Built on eight
non-negotiable commitments

Every architectural decision flows from these commitments. They are not aspirations — they are constraints.

01

Zero Cost Forever

Every tool, host, registry, and service uses a genuinely free tier. ZarishSphere will never pay a single penny.

02

Last Mile First

Offline capability, low bandwidth, and low-end devices are first-class requirements. Full FHIR engine runs on Raspberry Pi 5.

03

Config ≠ Code

Clinical content — forms, concepts, terminologies — lives in independent repositories and deploys independently of application code.

04

GitHub Governs

Every decision is an RFC. Every standard is an ADR. Every change is a PR. Nothing happens outside of GitHub.

05

SSOT Driven

Documentation as Code drives everything. If it is not documented, it does not exist. If it exists, it must be automatable.

06

No-Coder Friendly

GUI-first, template-driven, fully automated. No terminal required for platform operators. Approve, review, decide — that's it.

07

FHIR R5 Native

All clinical data is a FHIR R5 resource. No proprietary schemas. R4 bridge maintains compatibility with 73% of partner systems.

08

Zero Vendor Lock

Every component is self-hostable, open-source, and portable. If any vendor disappears tomorrow, ZarishSphere keeps running.

Everything a national
health program needs

Modular, independently deployable services. Plug in what you need. Leave out what you don't.

🏥

EMR / EHR Core

Patient registration, encounters, vitals, conditions, medications, allergies, procedures.

FHIR R5
🤱

Maternity

ANC/PNC workflows, delivery records, partograph, postnatal care, maternal mortality.

WHO Guidelines
👶

Child Health

Pediatric growth charts, EPI schedule, IMCI, development milestones, under-5 surveillance.

WHO Standards
🥗

Nutrition

MUAC, CMAM, SAM/MAM assessment, MIYCN, micronutrient supplementation tracking.

SMART Indicators
🧠

Mental Health

PHQ-9, GAD-7, MHPSS programs, psychosocial screening, crisis response workflows.

WHO mhGAP
🦠

Communicable Disease

CD surveillance, outbreak detection, EWARS integration, TB, malaria, cholera, COVID.

IDSR · IHR
🔬

Laboratory

Lab order management, result ingestion, HL7 v2 Lab ADT, LOINC-coded results.

LOINC 2.78
💊

Pharmacy

Formulary management, medication dispensing, stock integration, RxNorm coding.

RxNorm
📊

Public Health

Population indicators, WHO/UNICEF KPIs, DHIS2 export, aggregate reporting.

DHIS2
🗺️

Geo Health

Facility registry, GPS tracking, catchment areas, outbreak mapping, OpenLayers.

OpenLayers
👥

HRM

Staff registry, contracts, schedules, training records, payroll integration.

ERP
📦

Supply Chain

Medical stock, procurement, cold chain, expiry tracking, last-mile logistics.

ERP

Proven at planetary scale.
Free at every layer.

Every component is open source, self-hostable, and battle-tested in production at national scale.

LayerTechnologyVersionPurpose
GoGo1.26.1Primary backend language — Green Tea GC, single binary, Raspberry Pi 5 capable
Gochiv5.2.1Idiomatic HTTP router for FHIR REST API — no external dependencies
Gofhir-toolbox-golatestPrimary FHIR R5 engine — FHIRPath, search, pagination (damedic)
DataPostgreSQL18.3JSONB for FHIR resources · GIN indexes for O(log n) search
DataTimescaleDB2.17Time-series: vitals trends, lab timelines, indicators
DataNATS JetStream2.10.2420 MB RAM message broker — FHIR R5 topic subscriptions
DataValkey8.0Linux Foundation Redis fork — sessions, cache, rate limiting
DataTypesense28.0Typo-tolerant offline-capable search — patient names, notes
TSReact + Next.js19 + 15.3Microfrontend shell — Server Components, offline PWA
TSCarbon Design System11.xIBM health-focused component library — WCAG 2.2 AA
FlutterFlutter + PowerSync3.29Offline-first mobile — SQLite sync to PostgreSQL
InfraKeycloak26.1SMART on FHIR 2.1 · OAuth 2.1 · OIDC — self-hosted, free
InfraOpenTofu + Argo CD1.9.1 + 2.14IaC + GitOps — Linux Foundation fork of Terraform
InfraCloudflareFree tierDNS · CDN · Workers · R2 storage · Email routing

Built for South and
Southeast Asia

Each country gets its own distribution layer, infrastructure state, and adoption maturity score — fully independent, inheriting global defaults.

🇧🇩

Bangladesh

Active

Cox's Bazar Rohingya response + national health programs. Priority country with full distro configuration.

CAMM Progress: L1 Bootstrapping
🇮🇳

India

Planned

ABDM integration, national health ID, Ayushman Bharat program alignment, Hindi + regional languages.

CAMM Progress: L0 Interest
🇲🇲

Myanmar

Planned

Cross-border health, conflict settings, stateless populations, Burmese language forms.

CAMM Progress: L0 Interest
🇵🇰

Pakistan

Planned

National health system integration, Urdu language support, provincial health authority alignment.

CAMM Progress: L0 Interest

Twelve quality
commitments

Integrated

Coordinates OpenMRS, DHIS2, Go.Data, OpenIMIS — never replaces them.

Offline-First

Full clinical workflows without internet. Sync when connectivity returns.

Secure

HIPAA audit trail, GDPR right-to-erasure, SMART on FHIR 2.1, field-level encryption.

Interoperable

FHIR R5 + R4 bridge, HL7 v2.9, DICOM, ICD-11, SNOMED CT, LOINC.

Testable

Integration tests with testcontainers, automated FHIR validation, smoke testing on every deploy.

Harmonised

Content follows ICD-11, SNOMED CT, LOINC, CIEL, and WHO clinical guidelines.

Recoverable

Automated PostgreSQL backups to Cloudflare R2, Argo CD GitOps rollback.

Portable

Agnostic architecture — cloud, on-prem, hybrid, edge. One OpenTofu template per country.

Multilingual

English, Bengali, Burmese, Urdu, Hindi, Thai — UI and clinical forms.

Reliable

Redundancy, failover, and monitoring by design. Grafana alerting on every critical path.

Open

Apache 2.0. Every repository public. Every decision an RFC. Every dollar spent: zero.

Data-Driven

Quality information to the right people, at the right time. DHIS2 indicators, BI dashboards.

Five coordinated layers

From governance documents to edge infrastructure — every layer is independently deployable and governed through GitHub.

Layer 0 — Governance: RFCs, ADRs, CAMM, Documentation as Code
Layer 1 — Presentation: Next.js MFEs, Flutter mobile, Tauri desktop
Layer 2 — API: FHIR R5 engine, SMART on FHIR, NATS events
Layer 3 — Data: PostgreSQL JSONB, TimescaleDB, Typesense, Grafana
Layer 4 — IaC: OpenTofu, Helm, Argo CD, Kubernetes, Cloudflare
┌──────────────────────────────────────────┐ LAYER 0: GOVERNANCE & SSOT RFC · ADR · CAMM · DaC · Security ├──────────────────────────────────────────┤ LAYER 1: PRESENTATION (SaaS) Next.js · Flutter · Tauri (embedded FHIR) ├──────────────────────────────────────────┤ LAYER 2: API & INTEROPERABILITY FHIR R5 · SMART · NATS · HL7v2 · DICOM ├──────────────────────────────────────────┤ LAYER 3: DATA & ANALYTICS PostgreSQL · TimescaleDB · Typesense ├──────────────────────────────────────────┤ LAYER 4: INFRASTRUCTURE (IaC) OpenTofu · Helm · Argo CD · Cloudflare └──────────────────────────────────────────┘ Config inheritance (3-level cascade): zs-distro-core └── zs-distro-bgd └── zs-infra-bgd / cxb / camp-1w

212 repositories.
One naming convention.

Every repository follows zs-{layer}-{module}. Click any layer to see its repositories.

zs-svc-patientzs-svc-encounter zs-svc-observationzs-svc-medication zs-svc-immunizationzs-svc-condition zs-svc-procedurezs-svc-allergy zs-svc-appointmentzs-svc-document zs-svc-maternityzs-svc-child-health zs-svc-mental-healthzs-svc-nutrition zs-svc-laboratoryzs-svc-pharmacy zs-svc-ewarszs-svc-dhis2-bridge zs-svc-surveillancezs-svc-reporting zs-svc-analyticszs-svc-auth zs-svc-terminologyzs-svc-search zs-svc-notificationzs-svc-geo zs-svc-hrmzs-svc-inventory zs-svc-financezs-svc-logistics
zs-ui-shell-clinicalzs-ui-shell-ops zs-ui-shell-publiczs-ui-patient-registration zs-ui-encounter-formzs-ui-vitals-entry zs-ui-medication-managementzs-ui-appointment-scheduler zs-ui-clinical-noteszs-ui-dashboard-clinical zs-ui-dashboard-public-healthzs-ui-geo-mapping zs-ui-form-builderzs-ui-admin-console zs-ui-landingzs-ui-portal-patient
zs-content-forms-corezs-content-forms-maternity zs-data-icd11zs-data-snomed zs-data-loinczs-data-fhir-profiles zs-iac-platformzs-iac-dev-environment zs-iac-template-countryzs-infra-bgd zs-distro-corezs-distro-bgd zs-distro-bgd-cxbzs-distro-humanitarian

Built in public.
For the last mile.

Every repository is open. Every decision is an RFC. Every dollar spent is zero. Join us from the ground floor.