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!
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.
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:
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
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.
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.
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.
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!
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.
Thanks for doing what you do and for sharing your story!
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.
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).
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.
What you’ll hear from DAF folks is
“we have to sell everything we get in when we get it” -> not true, managed by disclosures
“Our job is managing volatility of the donated assets, so getting volatile assets would be bad for the fund, or possibly not allowed” -> not true, managed by disclosures
“DAFs are disliked because of asset stuffing, and on the down” -> true as to the first part. On and off legislative pushes centeraround getting 2-ish% a year as a mandatory donation, so you could be ahead of the curve on an ‘ethics’ basis with this as a rule.
“It’s impossible to value illiquid stock so we can’t get a proper deduction” -> not true, you can get an outside valuation, or see below on the secondaries
The scheme I’d suggest on a call would just be: find a friend who did well from your cohort, or pitch some of your VC allies that have helped on the board, see if anyone is willing to give it a try in the 10mm or so range. You’ll then need to find someone who wants this stock in the secondary market; this would be either the key partnership or the key staff you hire, and another reason to bring in the VCs here. You’d be able to accept any donor with stock that has a value in the secondary market.
One of the things we looked at was psychology on give now / give later, most founders are planning on mooning, and therefore want to give later. This lets them split the difference a little - deduction at current secondary prices, but they could hold off on selling and get more out to charity if the stock does well.
On valuation, to my mind the easiest path is finding a secondary buyer, then you’ve got an independent price.
We even ID’ed an Exec Director who wants to do this, and would be great! My contact is in my profile.
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?
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.
It’s not definitionally true, but it happens often enough that there’s no denying a clear trend.
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.
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”.
• 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).
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?
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.
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!
> 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.
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!
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)
I don't get this. Why wouldn't your normal healthcare cover the surgery?
Much more, 33,241.
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.
Lots of ways to keep score and count returns to investors.
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).
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!
