Free and Open Source Software (FOSS) has been widely accepted as an enabler of Information Communication Technologies (ICTs) establishing its foundation as a parallel Open ICT Ecosystem opposing proprietary or closed source development economics and usage. Adding to its popularity is adoption by Governments, International Development Organizations, Private and Civil Sectors of society as well as individuals that are inclined towards benefiting from this system of open, collaborative and inclusive software and hardware technology development. Within the scale of activities in a FOSS Ecosystem, stakeholders benefit from development methodologies that encapsulate local skill development, collaboration, innovation and local resources for technical support meaning, countries can develop FOSS tools and platforms within specialized areas of humanitarian social and economic development assistance including Health and Medical Services which in turn is a viable support towards the achievement of the UN Millennium Development Goals. FOSS can facilitate the creation of networks based on open content to enable easier discussion and exchange of clinical and medical data, electronic transmission of medical files and radiological pictures for small and medium enterprise as well as large scale hospitals employing FOSS based Medical and Clinical Hospital Information Management Systems. Amidst the fact that there are many such FOSS tools available for free usage within the developing world, many countries including Pakistan still lack the benefits that come with such technologies. This paper/presentation looks at the challenges faced by Pakistan towards the successful adoption of FOSS based Medical and Health Information Systems. - Fouad Riaz Bajwa - Pakistan