Thank HN: You helped save 33k lives

1148 points by chaseadam17 90 days ago | 112 comments

13 years ago, we launched Watsi.org with a Show HN [1].

For nearly a year, this community drove so much traffic that we couldn’t list patients fast enough. Then pg saw us on HN, wrote us our first big check, and accepted us as the first YC nonprofit (W13). The next few years were a whirlwind.

I was a young, naive founder with just enough experience to know I wanted Watsi to be more efficient, transparent, and innovative than most nonprofits. We spent 24/7 talking to users and coding. We did things that don’t scale. We tried our best to be walking, talking pg essays.

Over the years we learned that product/market fit is different for nonprofits. Not many people wake up and think, "I'd love to donate to a nonprofit today" with the same oomph that they think, "I'd love a coffee" or "I'd like to make more money."

No matter how much effort we put into fundraising, donations grew linearly, while requests for care grew exponentially. I felt caught in the middle. After investing everything I had, I eventually burned out and transitioned to the board.

I made a classic founder mistake and intertwined my self-worth with Watsi's success. I believed that if I could somehow help every patient, I was a good person, but if I let down some patients, which became inevitable, I was a bad person.

This was exacerbated by seeing our for-profit YC batch mates raise massive rounds. I felt like a failure for not scaling Watsi faster, but eventually we accepted reality and set Watsi on more of a slow, steady, and sustainable trajectory.

Now that I have perspective, I'm incredibly proud of what the org has accomplished and grateful to everyone who has done a tour of duty to support us. Watsi donors have donated over $20M to fund 33,241 surgeries, and we have a good shot of helping patients for a long time to come.

In a world of fast growth and fast crashes, here's a huge thank you to the HN users who have stuck by Watsi, or any other important cause, even when it's not on the front page. I believe it embodies the best of humanity. Thanks HN!

[1] http://news.ycombinator.com/item?id=4424081

aaur0 89 days ago |

I have been a Universal Fund member since 2014.

Watsi has this Impact page where you can see every person you've helped — their photo, their story, the country. I visit it more often than I'd like to admit.

I have been building a startup since the last couple of years and as we all know it is relentless. There are weeks where nothing seems to work, where you question every decision. In those moments, pulling up that page and seeing real people whose lives changed because of a few dollars a month — it resets something. It reminds me why building things that matter is worth the grind.

Thank you to everyone at Watsi for creating something that gives back to donors just as much as it gives to patients.

watsi 89 days ago | |

Thank you aaur0 - you have no idea how much this means to us. Grateful for every ounce of good news and good health we can spread in this world.

js2 89 days ago | |

> I have been a Universal Fund member since 2014.

I couldn't remember when I joined, but it turns out 2014 too. From that date and dang's comment below, I found the HN submission that motivated me to join:

https://news.ycombinator.com/item?id=7550005

chaseadam17 89 days ago | | |

That’s a very long time - thank you both!

aswerty 89 days ago | |

Another 2014 batch member here. Hard to believe it is over 10 years I've been contributing to Watsi.

kalvin 89 days ago |

Thank YOU Chase :) (I work at Watsi)

If you'd like to see an example of what Watsi's about, check out Philip's profile: https://watsi.org/profile/2286cb03a5bd-philip

Also, fun fact: 619 of our current "Universal Fund" monthly donors first made a donation 10 or more years ago, and I'm pretty sure many of those were/are Hacker News readers.

If you're interested, see https://watsi.org/universal-fund

maerF0x0 89 days ago | |

I've long played around with the thought of what would happen if someone started something like the universal-fund you mentioned, but had it snowball like a sovereign fund? (ie, instead of spending the in flow, invest it and only spend the profits from the investments, for example) ...

Particularly for basic needs like housing,food,clothes... Like what if instead of giving a charity $100 we created 41c per month? of UBI (roughly the cashflow from investing that same $100). Yes it would seem too little today, but in time it would be massive because it would never dissipate.

IDK, just my musing while claude takes, err does, my job.

MagicMoonlight 89 days ago | | |

Plenty of those have existed, but in the end they always get stolen and given to the dogs trust.

There’s nothing people hate more than lasting charitable foundations. They take them to court so that they can crack them open and wank away the entire fund in 6 months.

There was one which was supposed to pay off the entire national debt. They cracked and spaffed it.

Another was supposed to end piracy. Cracked and spaffed.

You could save a million people a year, but that won’t save you from being cracked and spaffed. They’re already rubbing their trotters at the thought.

luplex 89 days ago | | |

What you need to consider is that you also get compounding returns by treating a patient. They can now be more productive and contribute to their local economy. They might plausibly have a higher return rate (in wellbeing terms) than your alternative investment into stocks.

BobaFloutist 89 days ago | | |

That's called a foundation, they exist.

chaseadam17 89 days ago | | |

Love the idea and have long wanted something like this to exist. One other twist is you could let ppl vote on where to donate the profits.

rsynnott 89 days ago | | |

Some nonprofits do run largely off endowments.

One big issue is that it's a PR problem; most people don't really understand it. They'll look at the non-profit and say "why does that need to raise money, it's rich". You saw this a lot with Harvard in Trump's recent funding war with it, say.

doctoboggan 89 days ago | |

I remember Watsi being posted years ago. I was a recent graduate then and didn’t really have the funds but I do now so I just donated to Philip’s cause! Thank you!

kalvin 89 days ago | | |

Thank you so much! Here’s another patient link for other readers, since you fully funded Philip :P

Paw: https://watsi.org/profile/9dae70d8f758-paw

mclightning 89 days ago |

I made the biggest donations in my life via Watsi. Thank you for building this site. I love you guys have an API as well. I thought of building an app on top of your API but never got round to complete it. If you are curious, I can share; I think there may be an opportunity to capture value in free giveaways and turn it into charity. Many people try to give away their things quickly on fb marketplace or letgo, ...what if they could ask for a donation to a charity? I know there are challenges like, what if they want to return. But there has to be a way to solve this with an escrow service or something. A similar model already works in used, 2nd stores that work for charities.

volteret4 88 days ago | |

This idea is great!! I really think this can work, i think its a win-win situation form the buyer and even the seller. Thanks for sharing it!

Karupan 89 days ago |

Thank you for the incredibly inspiring work! At a time when 99% of the founders and VCs just want to bank on the next big hype cycle and accumulate power and wealth, it’s good to be reminded that actual life changing work with direct impact on people is still possible.

yakshaving 89 days ago |

I don't comment on Hacker News very much -- in fact, extremely rarely, but I do remember this more than a decade ago and its awesome that you've stuck with this for this long.

Congratulations to you and all the work that you've done and the impact that you've had. That's pretty cool and something I think many of us aspire to. Cheers Chase!

zachlatta 89 days ago |

Watsi is an incredible organization doing incredible work.

Chase and Grace are both incredible people.

When I was 15 and first starting Hack Club, I went to Startup School 2013 and watched Chase’s talk. It was the first time I had ever seen a startup founder who was starting a nonprofit instead of a for-profit. Afterwards he showed me the kindness of speaking with me.

Later as the years went on, both of them always replied to emails and gave great advice.

Many nonprofit founders understandably feel very protective of their experience and relationships because nonprofits can be zero-sum in a way that for-profits aren’t, but Chase and Grace are two of the most generous people you’ll ever meet.

Thank you for starting an incredible organization and being such an inspiration.

aftergibson 89 days ago |

You should be unbelievably proud of what you've achieved, and it's lovely to be reminded of the amazing things people can accomplish amongst the backdrop of almost deafeningly negative sentiment going around.

Thanks for doing what you do and for sharing your story!

chaseadam17 89 days ago | |

Thank you :) Watsi is lucky to have an incredible team and medical partners, who work in some of the most challenging environments to provide care to patients.

jbarrow 89 days ago |

Watsi is incredibly inspiring!

I’ve been a monthly donor since ~the beginning when I was just an undergraduate, and I still read the stories and emails I receive. I’m glad that you opted for the steady growth path, and that you’ve made it a sustainable thing.

watsi 89 days ago | |

Your support every month in our Universal Fund means the world to us! This consistency and reliability helps us plan ahead, show up faster for patients in need, and grow to reach new hospitals and communities.

chaseadam17 89 days ago | |

That's incredible. Monthly donors are Watsi's lifeblood - it is so impactful to be able to bet on receiving a certain amount each month - thank you!

BloondAndDoom 89 days ago |

You did a great thing! Thank you.

One thing I always thought of converging businesses with helping people in need.

I know a lot of people think about this in a negative way in charity circles but I’d rather like to see companies sponsor donate in return of some sort visibility.

Somehow I always thought that would be a good fit for an organization such as yours. (I did donate through you guys previously, thanks for facilitating that).

vessenes 89 days ago |

Chase,

I was an early donor and had forgotten about Watsi — thank you for the reminder and congratulations! You should be super proud. Plus, the experience you got here will serve you in good stead if you decide to do a commercial venture — scaling a non profit is much, much harder than a commercial company with some compounding finances.

That said, I have a pitch for you on Watsi - I continue to think Donor Advised Funds are underutilized financial tech in the US today. Watsi could set up a DAF that takes your cohort’s startup stock, gives them a tax deduction, mandates a 2-5% annual disbursement to the general fund if not otherwise allocated, and privilege the Watsi general fund. My team did a bunch of research on these a few years ago including some legal work, and I’d be happy to share if you think you might be interested in taking another crack at getting Watsi a large fund to back what it’s doing.

Either way - helping 33k people is incredible.

chaseadam17 89 days ago | |

I’m a fan of DAFs and agree they are underutilized. Getting ppl to donate stock might be hard but I’ll chat with Mackinnon, Watsi’s ED, about it and let you know if we have any questions. Appreciate the offer to help share research!

notpushkin 89 days ago |

Ohh, thanks for the reminder! I’ve been a Universal Fund member briefly, but I’ve lost my job soon after, and have had it paused since then. I do have some stable income again now – will resume my subscription later this month. :)

One thing I didn’t like back then (IIRC) was the fact that you couldn’t opt out of receiving the patient stories with your monthly receipts. While genuinely heartwarming, I’d prefer to check these out when I’m in the mood. Any idea if there’s such an option now?

watsi 88 days ago | |

We'd love to have you back! Just let us know and we can turn off the patient updates for you anytime.

nyddle 89 days ago |

That's incredible. Why even compare your startup to for-profits, while you actually make world a better place?

teekert 89 days ago | |

Why would for profits not make the world a better place?

For-profit does not mean “shareholders and ROI over user” or something. You can do for-profit and not enshtfy and make the world better. That’s my goal at least.

rlonn 89 days ago | | |

The comment is a bit misguided: the operations Watsi helps perform would not have been possible without for-profit companies and for-profit innovators building the infrastructure of modern medicine. It's not one or the other: both for-profits and non-profits make the world a better place and I think they complement eachother. Sure, there are for-profits that do NOT make the world a better place, just like there are non-profits that fail in their mission to do good things. They just typically fail to do good things for different reasons.

TimorousBestie 89 days ago | | |

> For-profit does not mean “shareholders and ROI over user” or something.

It’s not definitionally true, but it happens often enough that there’s no denying a clear trend.

i7l 89 days ago | | |

If profit is the objective, it will turn into growth-at-all-costs machine because that's how the mathematics works.

If, however, the objective is, say, improve as many lives as possible with the constraint of being profitable, it's definitely possible to do good. You just have to make sure you understand what level of profitability is sufficient, which is rare but doable.

tacone 89 days ago | | |

Value makes the world a better place, not profits per-se. Sometimes the two things coincide, sometimes they don't.

josuepeq 89 days ago | |

You’re sentiment is correct, but I also think that most Certified B Corporations arguably make the world a better place.

frankdenbow 89 days ago |

Great work Chase! I remember meeting you back in the shared office with Teespring. You are right, we are not our startups, but there is a lot to be proud of, an impact is always the goal, for profit or non. Onward!

chaseadam17 89 days ago | |

The old Teespring office, those were the days!

photon_lines 89 days ago |

Thank you Chase -- I was an early Watsi supporter (and still am actually) but you just reminded me I need to donate soon haha :) Either way fantastic work and thank you!

chaseadam17 89 days ago | |

Thank you so much!

jacquesm 89 days ago |

Watsi is without a doubt the best thing to come out of YC.

tristor 89 days ago |

Incredible, I didn't know about Watsi, but I am glad that I do now. Direct support for something as important as healthcare seems to be one of the best ways to deploy donations to positively impact the world. Thank you for creating this!

jtokoph 89 days ago |

We shared an office space with Watsi years ago in San Francisco. Chase, Grace and the rest of the team were amazing.

Chase: one thing that’s always stuck with me was when you talked about when you realized that you “can both do good and do well”.

yottamus 89 days ago |

I basically only trust GiveWell on global aid, have you been evaluated by them?

watsi 89 days ago | |

We'd love to have GiveWell evaluate Watsi. They often recommend global health interventions because every dollar goes incredibly far in saving lives. In the meantime, here's what a few (independent) experts have said about investing in access to surgery:

• A review across 23 LMICs found that low-complexity surgeries (e.g., appendectomy, hernia repair) cost as little as $17 per Disability-Adjusted Life Year (DALY) averted (Mengistie et al., 2025). Overall, 89% of surgical procedures studied were cost-effective, and 76% were “very cost-effective” based on GDP thresholds (Ifeanyichi et al., 2024). • Essential surgery often achieves costs per DALY well below standard willingness-to-pay thresholds and can be more valuable than essential drugs or vaccines on a per-DALY basis (Mengistie et al., 2025). Low-complexity surgical interventions compare favorably to—and are sometimes more cost-effective than—interventions such as HIV antiretroviral therapy, family planning, and TB vaccinations (Ifeanyichi et al., 2024).

staubfinger 89 days ago |

Love how watsi helped not only others but also also you; to grow as a person. Hope this will both never stop :)

Curious Question about Money and Logistics: If people from all over the world donate, how do you guys funnel/move the money to the places where they need to be? I can think of bank wire transfers, but i doubt that's the way you do it - so curious as to how its being done. Also: are fancy new cryptocurrencies of any use in transferring funds? could you see them ever be?

ninju 89 days ago |

Reposting the main URL so that it does not disappear

https://watsi.org/universal-fund

gkoberger 89 days ago |

Hey Chase! Congrats on everything you, Grace, Thomas and the rest of the team built. I know it wasn't always what you expected it to be from the inside, but from the outside nobody saw that. They just saw something amazing. Your Startup School talk is my favorite ever, and I'm lucky I got to work with you all those years ago. You built something incredible, and helped a lot of people.

chaseadam17 89 days ago | |

Thanks, Greg! We really appreciated all your help. Been too long.

nbush 89 days ago |

This post triggered a wave of bittersweet remembrance: when Watsi was announced I signed up and was genuinely excited for what I thought a well-positioned incubator like YC could accomplish in general redistribution. I was very wrong! But to see this not being a shutdown or acquisition announcement is heartwarming. Keep linearly existing!

ChrisMarshallNY 89 days ago |

Great to hear!

As someone that has been in the volunteer/NPO space for decades, it’s nice to hear stories like this, in this land of money-making. I confess that it can be difficult, when dealing with folks unable to even understand there are priorities other than money.

There’s certainly a need for your service, these days.

MASNeo 89 days ago |

That’s such an amazing story. I ca relate to much of the emotional, time and financial commitment of a non-profit and keeping at it like you have is absolutely commendable. Seeing you succeed is an inspiration to continue doing the right thing for me and for many others!

maybelsyrup 89 days ago |

Never heard of Watsi, but I just donated!!!

Grateful for your work, and sticking it out serving human beings while others hustle to secure the bag. There's nothing wrong with securing the bag, of course, but it just makes work like this even more impressive to me. Kudos!

watsi 89 days ago | |

THANK YOU! Welcome to Watsi!

Whitespace 88 days ago |

I've been with Watsi for almost 12 years now, most of that as a Universal Fund member. Like others, I love periodically checking the "My Impact" page, as it really humanizes my monthly donation.

> You've funded healthcare for 162 patients in 14 countries.

> You joined Watsi on February 26th, 2014. Eleven years ago, you became a member of our Universal Fund, supporting life-changing treatments for a new Watsi patient every month. Your most recent donation traveled 8,500 miles to support Leah, a poultry farmer from Kenya, to fund abdominal surgery.

kamens 89 days ago |

You, Thomas, Watsi, and crew have been an inspiration for a long time. I loved getting to know you all back in the day, and I've loved being a small donor since the early days. Deep respect for what you built.

Bob_LaBLahh 89 days ago |

I really admire what you folks are doing. You can count me as a new supporter.

igl 89 days ago |

First time seeing this. Really moving story.

I just set up a monthly donation and had one thought: the way to donate monthly feels a bit too hidden right now (did a ctrl+f search to find the footer link).

Much love to all of you!

watsi 87 days ago | |

This is really helpful feedback - our team will get to work on making this easier to find. Thanks for joining in and for all the kindness!

smoyer 89 days ago |

I was part of Omaze and can definitely empathize with the amount of work charitable fund raising takes and the amount of heartache that come from seeing under needs. Thanks for your hard work!

sskates 89 days ago |

Chase- thank you for what you've done in creating Watsi to impact 33,000 lives! It also made me believe in the potential for non profits to create a positive impact again.

coderintherye 89 days ago |

Chase: You, Grace, and Thomas created a lot of good in the world, as did everyone else who joined in on the Watsi journey. Was really proud to see all you accomplished!

dang 89 days ago |

Nice to hear from Watsi after all this time! Here's the original Show HN Chase linked to:

Show HN - We just built a site that saves lives - https://news.ycombinator.com/item?id=4424081 - Aug 2012 (183 comments)

... followed by the other threads I could find (in forward order for a change):

Meet Watsi, Y Combinator's First Nonprofit - https://news.ycombinator.com/item?id=5117385 - Jan 2013 (168 comments)

The Story of Bageshwori, Watsi's First Patient - https://news.ycombinator.com/item?id=5299910 - Feb 2013 (63 comments)

Watsi (YC W13) and the Future of Patronage - https://news.ycombinator.com/item?id=5445014 - March 2013 (11 comments)

Catching up with Watsi: Y Combinator’s first non-profit graduate - https://news.ycombinator.com/item?id=5508064 - April 2013 (20 comments)

PG chooses healthcare non-profit Watsi as his first board seat - https://news.ycombinator.com/item?id=5579353 - April 2013 (31 comments)

Watsi (YC W13) raises $1.2M first-of-its-kind 'philanthropic seed round' - https://news.ycombinator.com/item?id=6103506 - July 2013 (94 comments)

Watsi Lands $1.5M Donation From Humble Bundle - https://news.ycombinator.com/item?id=6916609 - Dec 2013 (20 comments)

A dose of perspective - https://news.ycombinator.com/item?id=7549245 - April 2014 (38 comments)

Stories from our first two years - https://news.ycombinator.com/item?id=8286476 - Sept 2014 (34 comments)

Universal Fund - https://news.ycombinator.com/item?id=8563558 - Nov 2014 (29 comments)

Saying Yes - https://news.ycombinator.com/item?id=9428403 - April 2015 (13 comments)

Watsi launches universal health coverage, funded by YC Research - https://news.ycombinator.com/item?id=15165111 - Sept 2017 (281 comments)

How we built Watsi Coverage without stable electricity, WiFi, or email - https://news.ycombinator.com/item?id=16398220 - Feb 2018 (25 comments)

cyrusradfar 89 days ago |

I've appreciated following your story. Happy that it's brought more meaning to your life and been a net-positive for the planet. That says a lot.

ohyoutravel 89 days ago |

No problem! I would absolutely help again. This is an important cause that is near to my heart. Speaking for the HN community: we are always happy to help!

cies 89 days ago |

This is my fav charity option. It's so hard some times to know where you can do maximum good with your money: Watsi might well be it.

watsi 89 days ago | |

So awesome to hear - thank you! Hoping others will join in on watsi.org to help too. We want giving to be a bigger and more meaningful part of our day to day lives and to do this, it helps to always know and trust the impact you are making.

iso1631 89 days ago |

> Watsi donors have donated over $20M to fund 33,241 surgeries

I don't get this. Why wouldn't your normal healthcare cover the surgery?

lanyard-textile 89 days ago |

:) Even saving 1 life is worth celebrating.

Much more, 33,241.

tnorthcutt 89 days ago |

My first donation to Watsi was on July the 6th, 2013. I continue to be impressed with the work your team does. Bravo.

jmathai 89 days ago |

Watsi remains the most inspiring things that’s happened on Hackers News since I joined. Well done Chase and Grace!

chirau 89 days ago |

Great work. Do you have specific countries you work with? How are health partners selected? Would love to introduce some doctor friends of mine in Southern Africa. Every now and then they have some cases where we end up just pooling as friends and send to them. Again, great work!

Uptrenda 89 days ago |

this organization helped me get a new anus. it was very inspiring. thanks, op.

siquick 89 days ago |

This is truly great - just joined the universal fund.

I tried to signup from the nav bar but kept getting a 500 error from the sign_up.json endpoint. I had to go through the Donate flow to be able to create an account.

kalvin 88 days ago | |

We just deployed a fix for this, thanks for reporting! (We recently enabled Cloudflare caching which exposed a pre-existing CSRF issue, now fixed)

domjmich 89 days ago |

Congratulations! I remember your launch all those years ago and am not surprised by your team's success. It's great seeing tech used for good.

user3939382 89 days ago |

If this world wasn’t run by disgusting psychopaths an organization like this wouldn’t be and shouldn’t be necessary but since it is, I applaud the work sincerely and wish you the best of luck.

czbond 89 days ago |

@chaseadam17 - What advice or lessons would you share for others looking to pursue a company which focuses on public good or nonprofit?

j45 89 days ago |

Great accomplishment, congrats. YC acts different and glad they helped make something happen.

Lots of ways to keep score and count returns to investors.

ricardobayes 89 days ago |

Wow this is special. I hope as AI scales, we can channel some of that growth into philantropy and non-profit (startups).

TheAtomic 89 days ago |

This is wildly cool. I donated to a patient and now make a very small monthly donations. #this

kinderjaje 89 days ago |

Nice story, glad to see launches like this and that is not all about self promotion and money.

chris_wot 89 days ago |

I'd be impressed if you would process my donation. Your platform says it can't right now.

kalvin 89 days ago | |

We can't see any failed donations around this time, and we've had many successful ones, so we'd love to get more info from you to debug if you're willing. My email is in my profile. Thanks so much for the help!

kalvin 88 days ago | |

Update: we just deployed a fix for this, thanks for reporting! (We recently enabled Cloudflare caching which exposed a pre-existing CSRF issue, now fixed)

snthpy 89 days ago |

It's ironic that the landing page shows people from around the world but the country where healthcare is least affordable is the USA.

davedx 89 days ago |

Happy to have donated! Amazing work.

zehagray 88 days ago |

Thank you for your work

syumpx 88 days ago |

congrats!

RGamma 89 days ago |

This thread gives me visions of a black mirror episode.

kittbuilds 89 days ago |

The observation about donations growing linearly while requests for care grew exponentially is one of the most honest descriptions of nonprofit scaling I have seen. Most founders in that position either burn out silently or pivot to a for-profit model. Choosing the slow, steady, sustainable path instead — and then coming back 13 years later to share what you learned — says a lot about character. 33k surgeries is remarkable. Thanks for sharing this.

ag8 89 days ago |

Watsi seems to be doing great work, but the title—"you helped save 33k lives"—reads as misleading to me. I guess "helped" could be doing a lot of heavy lifting here, but I would be incredibly surprised if the counterfactual number of lives saved was more than 3000. (But don't let this dissuade you from donating; concretely improving someone's life is totally a worthwhile goal, and Watsi seems very good at effecting this)

wizzwizz4 89 days ago | |

"Counterfactual number of lives saved" is not the normal sense of the phrase "save a life". By that logic, each person's life can only be saved once, which is not how people normally use the phrase.

Your definition may be useful for cold hard utilitarian calculus, of the sort that hospital directors need to do if they've run out of fundraising opportunities. However, "effective altruism" – which I suspect you're alluding to here – isn't actually an efficient way to save lives, the way it's usually practised (ignoring second-order effects, and everything that doesn't fit on a spreadsheet).

ag8 89 days ago | | |

You're right; I should've been more precise. However, we have tools for dealing with this—that's what quality-adjusted life-years are for! I don't contest that surgeries often significantly increase QALYs, and may do so pretty cost-effectively.

danparsonson 89 days ago | |

You must be fun at parties ;-)

ag8 89 days ago | | |

Lol, I just care a lot about saving as many lives as I can; the most effective charities I've been able to find good evidence on save one life for $6–8k. If Watsi had a credible claim at being able to save lives 10x cheaper I would redirect my entire donation budget to them!

That said, once again, Watsi is great. I really appreciate all the hard work they've put into making this happen—this is orders of magnitude more impressive and impactful than most projects I've ever seen!