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

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.

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

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.

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. Watsi also inspired Hack Club to make our finances 100% transparent from day 1.

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.

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.

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!

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!

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.

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).

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.

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.

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!

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!

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

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!

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

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

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!

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.

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!

:) Even saving 1 life is worth celebrating.

Much more, 33,241.

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.

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

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)

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

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

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)

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.

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!

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.