Posted by chaseadam17 13 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!
• 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).
Much more, 33,241.
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).
"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
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!
Lots of ways to keep score and count returns to investors.
The good news is God doesn't hold us responsible for them. He is sovereignly in control of the entire universe, including every life. He made us to worship and reflect Him, and love others as ourselves day by day. We're only judged for what we can actually do, more from the heart than anything.
That's a huge relief. I just help who I can. It's also awesome that, if we believe in Jesus Christ, we can pray fir them to be healed or for Him to raise up entire organizations to give people more medical care. We've seen some healings but usually exceptional, medical progress. (Some suffer or die.) On more care available, your team was one of our answered prayers. :)