Posted by chaseadam17 10 hours ago
Thank HN: You helped save 33k lives
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!
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!
Much more, 33,241.
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.
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.
It’s not definitionally true, but it happens often enough that there’s no denying a clear trend.
• 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).