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Posted by chaseadam17 11 hours ago

Thank HN: You helped save 33k lives

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

499 points | 61 commentspage 3
cyrusradfar 4 hours 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 5 hours 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!
sskates 6 hours 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.
chris_wot 2 hours ago||
I'd be impressed if you would process my donation. Your platform says it can't right now.
kalvin 1 hour 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!
lanyard-textile 3 hours ago||
:) Even saving 1 life is worth celebrating.

Much more, 33,241.

yottamus 5 hours ago||
I basically only trust GiveWell on global aid, have you been evaluated by them?
watsi 3 hours 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).

dang 6 hours 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)

Uptrenda 2 hours ago||
this organization helped me get a new anus. it was very inspiring. thanks, op.
ag8 5 hours 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 4 hours 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 4 hours 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.
kalvin 3 hours ago||
Yes they are surprisingly cost-effective in the countries Watsi operates in, which isn't intuitive for those of us who live in places where surgeries are very expensive.

"A review across 23 LMICs found that low-complexity surgeries (e.g., appendectomy, hernia repair) cost only about ~$17 per DALY, whereas even complex procedures were often cost-effective" (Most surgeries on Watsi are low-complexity)

"Reports from the WHO and Lancet Commission consistently emphasize that investing in surgical capacity has high value, in many cases, more than essential drugs or vaccines on a per-DALY basis"

Both quotes from: https://link.springer.com/article/10.1186/s12893-025-03204-0

danparsonson 4 hours ago|||
You must be fun at parties ;-)
ag8 4 hours 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!

danparsonson 2 hours ago||
Ah well then, please forgive my snark - you're right of course; I misread your intent with your original comment.
wetpaws 4 hours ago||
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j45 3 hours 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.

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