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:
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.
I've long played around with the thought of what would happen if someone started something like the universal-fund you mentioned, but had it snowball like a sovereign fund? (ie, instead of spending the in flow, invest it and only spend the profits from the investments, for example) ...
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.
Plenty of those have existed, but in the end they always get stolen and given to the dogs trust.
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.
This sounds like a strange set of examples that may have been scams from the start. Can you name them?
The UK is full of long lasting charitable foundations. Many attached to schools and universities, but the highest profile example is probably the National Trust and its collection of historic buildings.
A lot of those charities are precisely in the process of being "cracked open", or have been captured by small groups who manage them as their personal fiefdom. The level of everyday corruption in this country is incredible.
> captured by small groups who manage them as their personal fiefdom
Isn't that intrinsic to what a charity is? They don't have customers, they're not trusts set up on behalf of someone else specific, they're a tax exemption with an ideological mission.
The key there is "ideological mission", which is immediately abandoned in all but name in favor of slinging money around the non-profit industrial complex.
Edit: A great example that comes to mind for me is Wikimedia. They beg for money every year telling you that it's to keep Wikipedia running, but not only do they have enough money to keep running for years, not only is running Wikipedia not their main expense, but they redonate some of that money to other nonprofits. Even if you agree with the missions of those other nonprofits (which are not in line at all with the mission of Wikimedia), you're trusting that an organization that already lied to you about where the money is going is making good choices with that money.
> (still short on named examples in this subthread)
UK libel laws are no joke here, and coupled with the abandonment of basically any public subsidy for legal expenses of normal people, it means most people (me included) are not going to name names.
> The level of everyday corruption in this country is incredible.
Sounds like the solution is to stop trying to make something like that work in an environment (country) which sounds setup to prevent those sort of efforts. There are lots of countries out there, some are surely a better fit.
What you need to consider is that you also get compounding returns by treating a patient. They can now be more productive and contribute to their local economy. They might plausibly have a higher return rate (in wellbeing terms) than your alternative investment into stocks.
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.
And the biggest expense of the most successful charities is fund raising. It's a viscous cycle and when Watsi came along they showed maybe an alternative path.
I remember Watsi being posted years ago. I was a recent graduate then and didn’t really have the funds but I do now so I just donated to Philip’s cause! Thank you!
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.
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.
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!
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.
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.
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!
Thank you :) Watsi is lucky to have an incredible team and medical partners, who work in some of the most challenging environments to provide care to patients.
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.
Your support every month in our Universal Fund means the world to us! This consistency and reliability helps us plan ahead, show up faster for patients in need, and grow to reach new hospitals and communities.
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.
I’m a fan of DAFs and agree they are underutilized. Getting ppl to donate stock might be hard but I’ll chat with Mackinnon, Watsi’s ED, about it and let you know if we have any questions. Appreciate the offer to help share research!
“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.
Ohh, thanks for the reminder! I’ve been a Universal Fund member briefly, but I’ve lost my job soon after, and have had it paused since then. I do have some stable income again now – will resume my subscription later this month. :)
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?
Why would for profits not make the world a better place?
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.
The comment is a bit misguided: the operations Watsi helps perform would not have been possible without for-profit companies and for-profit innovators building the infrastructure of modern medicine. It's not one or the other: both for-profits and non-profits make the world a better place and I think they complement eachother. Sure, there are for-profits that do NOT make the world a better place, just like there are non-profits that fail in their mission to do good things. They just typically fail to do good things for different reasons.
If profit is the objective, it will turn into growth-at-all-costs machine because that's how the mathematics works.
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.
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!
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!
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!
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).
Love how watsi helped not only others but also also you; to grow as a person. Hope this will both never stop :)
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?
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.
This post triggered a wave of bittersweet remembrance: when Watsi was announced I signed up and was genuinely excited for what I thought a well-positioned incubator like YC could accomplish in general redistribution. I was very wrong! But to see this not being a shutdown or acquisition announcement is heartwarming. Keep linearly existing!
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.
That’s such an amazing story. I ca relate to much of the emotional, time and financial commitment of a non-profit and keeping at it like you have is absolutely commendable. Seeing you succeed is an inspiration to continue doing the right thing for me and for many others!
I've been with Watsi for almost 12 years now, most of that as a Universal Fund member. Like others, I love periodically checking the "My Impact" page, as it really humanizes my monthly donation.
> 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.
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, Thomas, Watsi, and crew have been an inspiration for a long time. I loved getting to know you all back in the day, and I've loved being a small donor since the early days. Deep respect for what you built.
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).
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!
Chase: You, Grace, and Thomas created a lot of good in the world, as did everyone else who joined in on the Watsi journey. Was really proud to see all you accomplished!
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.
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!
So awesome to hear - thank you! Hoping others will join in on watsi.org to help too. We want giving to be a bigger and more meaningful part of our day to day lives and to do this, it helps to always know and trust the impact you are making.
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!
This is truly great - just joined the universal fund.
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.
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.
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!
Update: we just deployed a fix for this, thanks for reporting! (We recently enabled Cloudflare caching which exposed a pre-existing CSRF issue, now fixed)
The observation about donations growing linearly while requests for care grew exponentially is one of the most honest descriptions of nonprofit scaling I have seen. Most founders in that position either burn out silently or pivot to a for-profit model. Choosing the slow, steady, sustainable path instead — and then coming back 13 years later to share what you learned — says a lot about character. 33k surgeries is remarkable. Thanks for sharing this.
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)
"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).
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.
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"
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 $6–8k. If Watsi had a credible claim at being able to save lives 10x cheaper I would redirect my entire donation budget to them!
That said, once again, Watsi is great. I really appreciate all the hard work they've put into making this happen—this is orders of magnitude more impressive and impactful than most projects I've ever seen!
There was a link posted here that showed some hernia surgery in Malawi costing 400$ , some others listed via links at 160$ to 1000$.
I honestly have no idea about healthcare costs in countries like that, but assuming the main cost is a surgeon, the reported median salary for surgeons in Sweden is between 110-150k usd yearly. Assuming 200 working days a year and available for something like 4 surgeries a day on average that goes to about 137 usd per surgery. Adjust for Malawi being a far cheaper country but addition of more staff and a cost of 400$ for a relatively minor surgery doesn't seem too far fetched if there isn't middlemen taking a cut (actually googling it seems like middlemen can take a fairly large cut even with those costs).
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 aaur0 - you have no idea how much this means to us. Grateful for every ounce of good news and good health we can spread in this world.
> I have been a Universal Fund member since 2014.
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:
https://news.ycombinator.com/item?id=7550005
That’s a very long time - thank you both!
@chaseadam17 -
This is where I learned about Watsi - https://www.youtube.com/watch?v=WlT3UhC7NwQ
I attended it in person. Very inspiring!
Another 2014 batch member here. Hard to believe it is over 10 years I've been contributing to Watsi.
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
I've long played around with the thought of what would happen if someone started something like the universal-fund you mentioned, but had it snowball like a sovereign fund? (ie, instead of spending the in flow, invest it and only spend the profits from the investments, for example) ...
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.
Plenty of those have existed, but in the end they always get stolen and given to the dogs trust.
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.
This sounds like a strange set of examples that may have been scams from the start. Can you name them?
The UK is full of long lasting charitable foundations. Many attached to schools and universities, but the highest profile example is probably the National Trust and its collection of historic buildings.
A lot of those charities are precisely in the process of being "cracked open", or have been captured by small groups who manage them as their personal fiefdom. The level of everyday corruption in this country is incredible.
> captured by small groups who manage them as their personal fiefdom
Isn't that intrinsic to what a charity is? They don't have customers, they're not trusts set up on behalf of someone else specific, they're a tax exemption with an ideological mission.
(still short on named examples in this subthread)
The key there is "ideological mission", which is immediately abandoned in all but name in favor of slinging money around the non-profit industrial complex.
Edit: A great example that comes to mind for me is Wikimedia. They beg for money every year telling you that it's to keep Wikipedia running, but not only do they have enough money to keep running for years, not only is running Wikipedia not their main expense, but they redonate some of that money to other nonprofits. Even if you agree with the missions of those other nonprofits (which are not in line at all with the mission of Wikimedia), you're trusting that an organization that already lied to you about where the money is going is making good choices with that money.
> (still short on named examples in this subthread)
UK libel laws are no joke here, and coupled with the abandonment of basically any public subsidy for legal expenses of normal people, it means most people (me included) are not going to name names.
> The level of everyday corruption in this country is incredible.
Sounds like the solution is to stop trying to make something like that work in an environment (country) which sounds setup to prevent those sort of efforts. There are lots of countries out there, some are surely a better fit.
It's pretty hard to move the National Trust for England preserving England's historic buildings to a different country. Sometimes things are local.
What you need to consider is that you also get compounding returns by treating a patient. They can now be more productive and contribute to their local economy. They might plausibly have a higher return rate (in wellbeing terms) than your alternative investment into stocks.
Precisely. Things become clear when we think of benefits for people instead of monetary terms.
That's called a foundation, they exist.
Love the idea and have long wanted something like this to exist. One other twist is you could let ppl vote on where to donate the profits.
Some nonprofits do run largely off endowments.
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.
And the biggest expense of the most successful charities is fund raising. It's a viscous cycle and when Watsi came along they showed maybe an alternative path.
I remember Watsi being posted years ago. I was a recent graduate then and didn’t really have the funds but I do now so I just donated to Philip’s cause! Thank you!
Thank you so much! Here’s another patient link for other readers, since you fully funded Philip :P
Paw: https://watsi.org/profile/9dae70d8f758-paw
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.
This idea is great!! I really think this can work, i think its a win-win situation form the buyer and even the seller. Thanks for sharing it!
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.
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!
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.
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.
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!
Thank you :) Watsi is lucky to have an incredible team and medical partners, who work in some of the most challenging environments to provide care to patients.
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.
Your support every month in our Universal Fund means the world to us! This consistency and reliability helps us plan ahead, show up faster for patients in need, and grow to reach new hospitals and communities.
That's incredible. Monthly donors are Watsi's lifeblood - it is so impactful to be able to bet on receiving a certain amount each month - thank you!
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).
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’m a fan of DAFs and agree they are underutilized. Getting ppl to donate stock might be hard but I’ll chat with Mackinnon, Watsi’s ED, about it and let you know if we have any questions. Appreciate the offer to help share research!
Totally!
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.
I wonder if some sort of partnership with https://forgeglobal.com/ could potentially help for syndicating to secondary buyers?
Nice idea! I didn't know about them, but yes, exactly
Ohh, thanks for the reminder! I’ve been a Universal Fund member briefly, but I’ve lost my job soon after, and have had it paused since then. I do have some stable income again now – will resume my subscription later this month. :)
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?
We'd love to have you back! Just let us know and we can turn off the patient updates for you anytime.
That's incredible. Why even compare your startup to for-profits, while you actually make world a better place?
Why would for profits not make the world a better place?
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.
The comment is a bit misguided: the operations Watsi helps perform would not have been possible without for-profit companies and for-profit innovators building the infrastructure of modern medicine. It's not one or the other: both for-profits and non-profits make the world a better place and I think they complement eachother. Sure, there are for-profits that do NOT make the world a better place, just like there are non-profits that fail in their mission to do good things. They just typically fail to do good things for different reasons.
> For-profit does not mean “shareholders and ROI over user” or something.
It’s not definitionally true, but it happens often enough that there’s no denying a clear trend.
If profit is the objective, it will turn into growth-at-all-costs machine because that's how the mathematics works.
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.
Value makes the world a better place, not profits per-se. Sometimes the two things coincide, sometimes they don't.
You’re sentiment is correct, but I also think that most Certified B Corporations arguably make the world a better place.
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!
The old Teespring office, those were the days!
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!
Thank you so much!
Watsi is without a doubt the best thing to come out of YC.
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!
We shared an office space with Watsi years ago in San Francisco. Chase, Grace and the rest of the team were amazing.
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”.
I basically only trust GiveWell on global aid, have you been evaluated by them?
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).
Love how watsi helped not only others but also also you; to grow as a person. Hope this will both never stop :)
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?
Reposting the main URL so that it does not disappear
https://watsi.org/universal-fund
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.
Thanks, Greg! We really appreciated all your help. Been too long.
This post triggered a wave of bittersweet remembrance: when Watsi was announced I signed up and was genuinely excited for what I thought a well-positioned incubator like YC could accomplish in general redistribution. I was very wrong! But to see this not being a shutdown or acquisition announcement is heartwarming. Keep linearly existing!
Great to hear!
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.
That’s such an amazing story. I ca relate to much of the emotional, time and financial commitment of a non-profit and keeping at it like you have is absolutely commendable. Seeing you succeed is an inspiration to continue doing the right thing for me and for many others!
I've been with Watsi for almost 12 years now, most of that as a Universal Fund member. Like others, I love periodically checking the "My Impact" page, as it really humanizes my monthly donation.
> 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.
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!
THANK YOU! Welcome to Watsi!
You, Thomas, Watsi, and crew have been an inspiration for a long time. I loved getting to know you all back in the day, and I've loved being a small donor since the early days. Deep respect for what you built.
First time seeing this. Really moving story.
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!
This is really helpful feedback - our team will get to work on making this easier to find. Thanks for joining in and for all the kindness!
I really admire what you folks are doing. You can count me as a new supporter.
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!
Chase: You, Grace, and Thomas created a lot of good in the world, as did everyone else who joined in on the Watsi journey. Was really proud to see all you accomplished!
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.
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)
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!
> Watsi donors have donated over $20M to fund 33,241 surgeries
I don't get this. Why wouldn't your normal healthcare cover the surgery?
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.
So awesome to hear - thank you! Hoping others will join in on watsi.org to help too. We want giving to be a bigger and more meaningful part of our day to day lives and to do this, it helps to always know and trust the impact you are making.
:) Even saving 1 life is worth celebrating.
Much more, 33,241.
Watsi remains the most inspiring things that’s happened on Hackers News since I joined. Well done Chase and Grace!
My first donation to Watsi was on July the 6th, 2013. I continue to be impressed with the work your team does. Bravo.
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!
this organization helped me get a new anus. it was very inspiring. thanks, op.
This is truly great - just joined the universal fund.
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.
We just deployed a fix for this, thanks for reporting! (We recently enabled Cloudflare caching which exposed a pre-existing CSRF issue, now fixed)
Congratulations! I remember your launch all those years ago and am not surprised by your team's success. It's great seeing tech used for good.
@chaseadam17 - What advice or lessons would you share for others looking to pursue a company which focuses on public good or nonprofit?
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.
Great accomplishment, congrats. YC acts different and glad they helped make something happen.
Lots of ways to keep score and count returns to investors.
Wow this is special. I hope as AI scales, we can channel some of that growth into philantropy and non-profit (startups).
This is wildly cool. I donated to a patient and now make a very small monthly donations. #this
Nice story, glad to see launches like this and that is not all about self promotion and money.
I'd be impressed if you would process my donation. Your platform says it can't right now.
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!
Update: we just deployed a fix for this, thanks for reporting! (We recently enabled Cloudflare caching which exposed a pre-existing CSRF issue, now fixed)
Happy to have donated! Amazing work.
It's ironic that the landing page shows people from around the world but the country where healthcare is least affordable is the USA.
Thank you for your work
congrats!
This thread gives me visions of a black mirror episode.
The observation about donations growing linearly while requests for care grew exponentially is one of the most honest descriptions of nonprofit scaling I have seen. Most founders in that position either burn out silently or pivot to a for-profit model. Choosing the slow, steady, sustainable path instead — and then coming back 13 years later to share what you learned — says a lot about character. 33k surgeries is remarkable. Thanks for sharing this.
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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)
"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).
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.
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
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You must be fun at parties ;-)
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 $6–8k. If Watsi had a credible claim at being able to save lives 10x cheaper I would redirect my entire donation budget to them!
That said, once again, Watsi is great. I really appreciate all the hard work they've put into making this happen—this is orders of magnitude more impressive and impactful than most projects I've ever seen!
There was a link posted here that showed some hernia surgery in Malawi costing 400$ , some others listed via links at 160$ to 1000$.
I honestly have no idea about healthcare costs in countries like that, but assuming the main cost is a surgeon, the reported median salary for surgeons in Sweden is between 110-150k usd yearly. Assuming 200 working days a year and available for something like 4 surgeries a day on average that goes to about 137 usd per surgery. Adjust for Malawi being a far cheaper country but addition of more staff and a cost of 400$ for a relatively minor surgery doesn't seem too far fetched if there isn't middlemen taking a cut (actually googling it seems like middlemen can take a fairly large cut even with those costs).
Ah well then, please forgive my snark - you're right of course; I misread your intent with your original comment.