
Meet Watsi, Y Combinator's First Nonprofit - pg
http://ycombinator.com/watsi.html
======
tptacek
This is great. I did what you asked and used the site and it is indeed
extraordinarily compelling. I might suggest a move away from Paypal (only
because the Paypal checkout experience is more intrusive and annoying than the
state of the art).

Our annual all-hands summit is next week, and we'll look for ways to work this
into our charity match programs. Many people on HN have companies with
employees; we were told about running charity matches by other friends who
have companies and let me pass the message along: they work really well. Match
programs have generated more goodwill for us than bonus programs. Start a
match program!

I have a question:

The big charity in this space is Partners In Health, which has an extremely
positive reputation (their cofounder is also now the President of the World
Bank), spends 94% of their funding on program expenses, and has a CEO who
makes less than 6 figures. (PIH is apparently a medical partner for Watsi).

Is the advantage of Watsi over PIH that 100% of funds go to program expenses,
rather than 94%? Or is it that fine-grained funding is more compelling and
will thus elicit more donations?

~~~
chaseadam17
All of the treatments funded on Watsi are provided by our partner
organizations (names listed on the patient profiles) and our first partner,
Nyaya Health, is a Partners in Health clinic in Nepal.

So in short, the benefit of Watsi is both of those you described. 1) 100% of
funds directly fund treatments and 2) those treatments are performed by great
organizations like Nyaya.

~~~
tptacek
Is there a kind of care I'd be funding using Watsi that I wouldn't be funding
as effectively if I routed contributions directly to PIH?

Or is the big advantage to Watsi (from a 1000ft view) that it creates an
especially compelling way to get people to contribute on-the-ground operating
funds to places like PIH?

The latter is certainly a huge big deal, in case I sound skeptical. I'm just
trying to refine my understanding of how all this stuff works.

Congratulations on all of this.

~~~
chaseadam17
Really insightful question. With Nyaya Health (the PIH org) we're funding
treatments they don't normally provide their patients (specialty referral
care, think heart surgery and the like), so yes, there's a big difference
between funding organizations directly and funding via Watsi.

Here's a link to the first patient we funded via Nyaya
([http://www.flickr.com/photos/nyayahealth/8405959818/in/photo...](http://www.flickr.com/photos/nyayahealth/8405959818/in/photostream)).
She had to take a 72-hour trip from Far Western Nepal to Kathmandu to receive
life-saving heart surgery. This is a pretty expensive endeavor by Nepali
standards ($1,125 USD), and without funding from an organization like Watsi,
specialty care for individual patients like Bageshwori is out of the question.

~~~
tptacek
Wow. There are treatments PIH can only provide in Nepal because of a site you
built? That is completely amazing. Congratulations.

------
kevinalexbrown
Aside from the human connection mentioned in the post, by far the most
compelling aspect to me is the "fixed" attribute. There's something so
satisfying about isolating a problem, then fixing it.

Many charities feel like an investment. This feels like a transaction.

Edit: Here by transaction, I mean it's something that has a very high chance
that it's working out. When I order a shirt online, there's a high probability
it will get to me. When I fund a new t-shirt company on Kickstarter, it's less
certain.

~~~
dm8
I agree on the point of transaction vs investment part of non-profit. CRY
(<http://america.cry.org/site/index.html>) has been doing it for years for
educating children and they are quite successful (what I've heard).

------
glimcat
So, the really cool part is this:

"At Watsi, 100% of your donations directly fund medical treatments. Watsi.org
is separately funded. They pay all their operational costs from their own
funding, and none from your donations. They even eat the credit card
processing fees."

This works great with Watsi's crowdfunding-style model. It probably wouldn't
help with things which need legs on the ground full-time, but it would be
interesting to see more nonprofits looking at an "out of channel" donor model.

P.S. If you haven't clicked through to read PG's announcement and check out
Watsi, go do so. Really. This is something YC is going to look back on and be
proud of being part of 20 years from now.

<https://watsi.org/faq>

~~~
dmoney
_So, the really cool part is this:

"At Watsi, 100% of your donations directly fund medical treatments. Watsi.org
is separately funded. They pay all their operational costs from their own
funding, and none from your donations. They even eat the credit card
processing fees."_

It doesn't sound (as) cool me if the founders can only do this until they go
broke. It looks like they do accept direct donations to fund their operating
costs, but it seems to me that the demand (if that's the right word for the
desire to donate) might not increase at the same rate as the demand to fund
treatments (and therefore costs for credit card fees, hosting, staff)
increases. Better to take a percentage and be transparent about what you use
it for.

~~~
chaseadam17
Very good point. We certainly don't want to go broke!

However, we feel very strongly that Watsi should be run like a successful
startup, and _not_ like a traditional non-profit.

Sustainability is extremely important to us. I'm a terrible fundraiser, and I
want nothing more than for us to cover our own overhead.

However, it just doesn't make sense to implement revenue generating features
(e.g. take a cut of donations, which to be clear we will never do) until we
hit scale. Right now, we're entirely focused on improving our product,
speaking with donors, and maximizing our impact.

However, just like any successful startup, there will (hopefully) come a time
when the costs associated with scale begin to outstrip the seed-support we've
so generously received from people like pg and Jessica. When that happens, we
will implement features that generate revenue for our organization, and we'll
have a user base large enough to make those features viable.

Without going into too much detail, those features will include things like
asking donors for an optional "tip" to Watsi when giving to a patient
(expected to net 6-8%), cause marketing products (already a few companies
interested), white label, etc.

We will never abandon the 100% model, and I'm completely confident that for as
long as there is demand for the service we're offering, we'll find a way to
cover our overhead.

~~~
fatbat
Interesting. What Watsi has is beyond what I imagined an ideal online
donations would offer.

Kudos for taking the leap Watsi!

------
PabloOsinaga
We (masporloschicos.com) have been doing roughly the same since 2005. (instead
of health we focus on malnutrition)

Note- site is in spanish - targeted to the Argentine audience

We are a bit less granular though - instead of matching against an individual,
we match a specific soup kitchen. But we keep donors updated with newsletters,
pictures, letters from the kids and so on.

edit: this level of udpates keeps donors engaged. we dont allow one time
donations - instead we require you to subscribe.

When we built masporloschicos.com I wanted to do it more granular (individual
level), but we ended up doing it a bit more aggregate because it was really
hard / expensive to get to that granular level.

I wonder how is watsi tackling this problem - because ultimately you don't
want to spend a lot of funds (regardless of where they come from) on the
administration/bureaucracy required to provide quality 1:1 matching.

So I just wonder how are they doing it?

~~~
irollboozers
The issue of administration and bureaucracy is definitely one the best
questions and hardest challenges for new startups trying to tackle these kinds
of peer-connected problems. There are entire systems of middle-men built up
over long periods of time that up until the internet have been how systems
like medical treatment, education, and research funding operate. The biggest
factor of inertia in these systems is the system itself.

Sites like Watsi are now making people realize two things: which
inefficiencies we can cut away, and that simple experiences like funding
medical treatment can be enhanced. Those are two very big revelations that
will fuel so much of peer-to-peer funding.

------
corin_
I'm personally not a fan of the concept of donating to help a specific person,
rather than a cause, but am unsure whether I'm a rare exception or whether
many people have the same view as me - hopefully a few replies could help
answer this?

When I say not a fan of the concept, I absolutely don't mean I disapprove. I
don't have any problem with organisations raising money this way, nor with
people choosing to donate money this way - I simply don't like donating
myself.

Trying to chose between fighting HIV or starvation, cancer or... etc. etc. is
hard enough. Looking at Watsi's homepage, does Chimwemwe from Malawi deserve
my money more than Kirshan from Nepal? What about Lidiya from Malawi? I can
see the point of view that it's nice to know your money has _definitely_ made
an impact on somebody's life, but personally I don't enjoy the burden of
making that decision. I'd far rather be 0.0000000001% of a big solution than
100% of a small one when it comes to charitable donations.

All that said, the fact that I dislike it doesn't take anything away from my
thinking that Watsi looks like a great site, my opinion doesn't change the
fact that anyone raising money for good causes is great and if the method used
here helps that then no complaints from me.

~~~
chaseadam17
Great point. It's all about personal opinion. There are currently tons of
organizations that enable people to fund a cause, but nearly none that let you
fund something as specific as an individual treatment. We're providing a new,
more direct and transparent, alternative.

Oftentimes there is institutional support for specific "mainstream" conditions
(e.g. HIV, TB, etc.) and as a result, some patients who are in unique
situations (e.g. have a rare condition, need a slightly expensive treatment,
need referral care, etc.) often fall through the cracks. Watsi provides an
opportunity to those patients by enabling them to tap into the crowd.

While there are pros and cons to each approach, it's important to note that
they are complementary. Charitable giving is not a zero sum game, and we're
working hard to expand the pie, not take a piece of it.

~~~
corin_
I wonder if everyone who has come across both options (broad vs. specific)
choses one and sticks with that, or whether some people like both and split
their donations?

While you'd obviously always prefer to expand the pie rather than just take a
piece, there's nothing wrong with the latter - like you said, your approach
can help people who slip through the gaps, so even if the pie doesn't expand,
your taking a piece of it can still be a good thing.

Keep up the good work.

~~~
chaseadam17
Great insight. We're in the process of creating a "General Fund" on Watsi to
help us answer that very question.

Donors that are interested in maximizing impact, and not necessarily
interested in helping a specific person, can give to that fund. We'll then use
those donations to support organizational projects (e.g. $1 vaccinations and
the like).

We're considering leveraging an organization like GiveWell to help us identify
organizations and projects that will be beneficiaries of the general fund.

------
SoftwareMaven
This is really cool, but I'm curious how an investment in this is different
than a charitable contribution. The contribution is awesome for the network it
introduces Watsi to, but I can't imagine there will ever be a return on this
kind of investment.

(This is _not_ meant to sound negative. I am truly excited to see it,
interested to see what the YC network can bring to it, and very curious about
the investment thinking behind it.)

~~~
pg
There is no difference; it is simply a charitable contribution.

~~~
tikhonj
Will they also be going through dinners, office-hours and the like?

I could see this being a good way to help new non-profits get over the initial
hump of raising awareness, getting administrative issues sorted out and so on.
Certainly a service worth more than just the money provided.

~~~
pg
Yes, everything is the same. They're going to present at Demo Day too (lots of
rich people in that room).

~~~
SoftwareMaven
That is awesome. A really great use of the YC network.

------
jkuria
This is really great to see. I am just curious, how do they ensure that the
funds are actually used for the intended person's health issues? How do you
prevent scammers and posers who just want to get money? I have a bit of
experience here and would say it is a non trivial problem if you do not have
an operation on the ground. You could donate to organizations that you trust
but then you get back to the same old problem: Distance from the human face
and actual life you are impacting.

For those of you who want to donate to non health related issues there is also
SeeYourImpact.org founded by Scott Oki, one of Microsoft's early execs. They
also ensure 100% of the donation goes to the person and absorb all the
overhead expenses.

Shameless plug: For our Hacker News Clone for African startus, business and
technology we will be running ads for SeeYourImpact.org but strictly for
educational needs. Check out the site here: <http://AfriTech.org/about.htm>
Actual news stories on front page: <http://AfriTech.org>

~~~
chaseadam17
We prevent scammers by going through trusted organizations. The funds go
directly to the organization that is providing treatment (i.e. the hospital or
clinic), and never into the hands of the patient.

As well, patients aren't able to solicit Watsi funding. In fact, they don't
even know we exist until a doctor at one of our partner organizations has
identified them as a candidate and presents them with the opportunity to have
their care funded by Watsi. You can think of us as an "Emergency Fund" for on-
the-ground healthcare providers.

~~~
gruseom
This is all tremendously innovative and exciting, and you are doing a superb
job of articulating it.

------
jango
In Slovakia (a small EU country) we have a non-profit called "Dobry anjel"
(Good angel) which helps families of children sick with cancer and other
serious diseases. It is also collects donations, is separately funded and
distributes all the donations "up to the last cent". Two possibly interesting
tidbits: 1) The organization has re-distributed almost 17 million euros since
its inception in 2006 (this is 23 mil. USD, over half a million USD in the
last month alone -- our population is about the same as Minnesota), 2) Its co-
founder Andrej Kiska is planning to run for president of Slovakia next year.

EDIT: Note on transparency: all the donors have their own website login
information ("angel ID") to track every donation and see exactly how much was
sent to whom. The stories of recipient families are provided, along with their
address + telephone number. The donors have an option to remain anonymous or
reveal their contact information. I never contacted any recipients or revealed
my name to them but I have heard stories where the donors and families in
distress got in touch and supported each other with prayers, encouragements,
etc.. "Good angel" also makes it possible to keep sending donations to the
same families if you choose to (otherwise the families will be chosen at
random, which is the default choice -- or at least was the default for me when
I signed up in 2007).

------
eranation
I'm so glad this was funded, I remember when it was initially posted, and the
simple, brave solution, and I salute to YC for funding and mentoring this.

One small thing, although I just donated 50$ for two people, I found myself to
be a bit uncomfortable with my actions,

I didn't really pay attention much to who I'm donating to, just clicked on the
first picture that caught my eye without thinking, and donated 25$. Then I
noticed, I'm donating to a 1 year old baby, with a cute photo. I really want
to think of myself as someone who pays more attention, reads and makes a
decision based on facts, medical condition, urgency, and likelihood to
succeed, but no, I just clicked based on prejudice, 1 second first impression,
biased decision, without noticing I did so.

Then I saw a 37 years old woman and noticed she got much less donations
although her total needed amount is higher, perhaps her medical situation is
less severe, but I would be naive to think that that's the only reason. So I
asked myself, am I doing some sort of unconscious decision that is not really
fair and unbiased? I would lie if I say I didn't.

So I donated 25$ to her as well, just so I feel a little better with myself,
and then I thought, well, this is a feature request.

So to avoid the "cute baby gets more donations" bias, what would make it a
little nicer to me is to donate without knowing who it goes to, I'd like a
button that says - "donate to most medically severe case", or "donate to most
time sensitive case" and have someone else make the decision. This will make
me feel a little more in peace with myself, and actually might make such
biases less common. Right now it might not have affect, but as it will
hopefully grow to help more people, having such "donate to who needs it most
medically" option will help prevent such gaps.

Also moving to a better payment system, Stripe or even Google checkout will
make it a much nicer experience.

EDIT: the baby's profile was on the home page, where as the woman's profile
was one click deeper, so this could be another reason, but this brings another
enhancement, please automatically promote / rotate profiles that have less
donations / most urgent medical conditions to the front page

Another feature I'm missing is to allow subscription, I would think many would
be happy to donate 5$-20$ a month and automatically give it to those who have
the least donations, or must urgent medical condition. Getting traffic is hard
and critical for making this work, and not every day you get to HN front page,
I would take advantage of it and offer a recurring donation as soon as
possible.

~~~
DigitalJack
It sounds to me like that what you want to work with is the more traditional
charity model. You don't know who your funding will support generally, you can
subscribe, they have staff that steer the funding toward the most urgent
needs.

So have a look at the Medical Partners that Watsi uses. See about donating
there.

------
suchow
This is a neat idea.

I have an unimportant question. PG's post says "They even eat the credit card
processing fees", but Watsi's FAQ says, "As part of the cost of the treatment,
we have included PayPal credit card processing fees (2.9% + $0.30 per
transaction). These PayPal fees are unavoidable, and no portion of the fees go
to Watsi."

Who is right?

~~~
bdcs
Good question. Also, PayPal fees are only unavoidable at PayPal. Would it be a
conflict of interest, on pg's part, to include donations via bitcoins using
Coinbase? If so, what if a competitor, such as BitPay, was used?

~~~
chaseadam17
We're switching over to Stripe and they've been kind enough to hook us up with
a better deal than PayPal (we'll be paying cost which is something like 2.4%
flat, inclusive of Amex and international transactions, which constitute more
than 30% of our total donations).

~~~
ianstormtaylor
Was just about to ask about Stripe helping out a charity and fellow YCer.
Awesome to here that they are hooking you guys up. Even with Paypal I already
went through 4 donations or so, but Stripe would make the process even more
addicting.

~~~
chaseadam17
Thank you for donating! It's amazing for us to hear from people that have
already supported so many patients on Watsi.

~~~
ianstormtaylor
If you guys remember my credit card between donations and give me an account
that will notify once a month (or so) of new patients, it'll actually become a
problem for my bank account.

------
eduardordm
pg,

I wrote this minutes ago in a thread about the 3rd world. If you ever come
across a startup that solves this please fund them:

"The biggest problems right now involve education and health. Example: 60-80%
health problems follow the same pattern: you see a doctor, he asks for
blood/urine tests, you get the results, go back to the doctor for a
prescription. Build something that the poor can explain their symptoms and do
those tests without going physically to a doctor and become a semi-god here.
That would involve a website (or phone call) and portable blood testers.
(Specially for things like malaria, E. coli, colera, dengue fever, typhoid
fever, etc)"

~~~
dreamdu5t
This would be illegal in the US AFAIK. The law and the US government are the
biggest barriers to medical innovation right now.

~~~
tnorthcutt
Isn't eduardordm specifically talking about 3rd world countries, e.g. not the
U.S?

~~~
TeMPOraL
Probably some of the US regulations would be relevant for US-based startups
trying to develop and test the technology locally, even if it is to be used in
3rd world countries later.

------
tsycho
On one hand, I love it that I was able to donate to a person, and Watsi didn't
require a login, email etc. (though I guess they have my email from the Paypal
payment).

But this is one of the sites where a login would probably be a good idea, so
that I can keep track of my donations and particularly the status/health
updates of those whom I am helping, and also potentially for tax purposes.

Another site on these lines which I like a lot is Kiva.org (no affiliation,
just a user). It's micro-finance, not donations, but all 3 people whom I lent
to on Kiva, have paid me back so their enterprise has presumably succeeded. It
feels great to be able to help some poor villager in Africa buy some
fertilizers or a cow, and I like how Kiva makes it easy to keep track of them
:)

Update: Watsi just emailed me a receipt that I can use for tax purposes, and
promised to send me a email when the person I donated to receives treatment.
So I take back my minor complaint above!

~~~
chaseadam17
This is a great suggestion. We do send updates to all donors, but as soon as
we integrate Stripe we're going to enable _optional_ user accounts. These
accounts will enable us to create new features like one-click donation
checkout, recurring donations, and a donation history so you can easily view
all the patients you've helped support. If you have any other ideas, please
let us know!

------
justjimmy
Previous discussions about Watsi. Good to see they're getting more exposure.

"Thank You HN: From 30 people whose lives you saved"
<http://news.ycombinator.com/item?id=4815006>

"Show HN - We just built a site that saves lives"
<http://news.ycombinator.com/item?id=4424081>

------
sethbannon
Very happy to see this. At the very least, it's great news for the nonprofit
world, which needs desperately to learn some of the basic the lessons of the
startup world: fail fast, iterate, focus on your users, and more.

~~~
jk4930
Would be interesting to observe how the established nonprofits react to this.
Many of them do the following: Make their target audience (who they claim to
care for) more dependent (i.e., don't solve the problem, just give some
temporal ease) and take money from third parties (state, private donors) that
don't control them.

My guess is that they would come up with many arguments against this startup-
ish approach and would lobby for legal barriers.

~~~
tptacek
Watsi is already working with huge names in this space. PIH, one of the best
known, funds on-the-ground medical care in places like Haiti and Subsaharan
Africa. I don't think anyone in these places cares how "dependent" they are on
PIH; their kids are living with broken femurs, infected bones, cataracts, and
hernias.

Charities are not going to lobby against Watsi.

~~~
jk4930
Thanks for the info. I didn't intend to imply that they (or other nonprofit
startups) would face opposition by all established players. It's just that I
found many "nonprofits" showing questionable behaviours: The people working in
the field are often very interested in helping, (some but important) people in
the administration became cynics or bigots and working for a nonprofit became
less of a mission and more of a job option and power play and protecting their
org's income streams and spheres of influence is more important than helping.

This is a POV from Germany where you have a wealthy population willing to
donate and many sharks eager to catch the fish. Add to this that some legal
circumstances make it possible for the established players to keep fresh
competition out of public money streams or eat plenty of the private donor
money (e.g., up to 49% for admin costs).

~~~
tptacek
I'm sure this is true of a lot of charitable endeavors, but the health care
charities are generally about getting medical teams on the ground and
deploying desperately needed care.

It makes sense to route contributions to reputable charities. In the medical
space, you have not only PIH but also organizations like Médecins Sans
Frontières/DWB-USA. One of the very cool things about what Watsi is doing is
that they provide a front end that routes contributions to multiple reputable
on-the-ground health care providers, like PIH clinics.

~~~
jk4930
Yes to all of the above. And I think there are other days when I can express
my concerns, now it's time that I start celebrating Watsi's success. :)

------
kalvin
Watsi is awesome. Kiva and donorschoose made "direct" p2p lending/giving
popular long ago, but Watsi is the first that feels like, well, a YC startup
(just from the site-- product, team, mentality).

Also be sure to check out givewell.org for very HN-friendly
(rational/research-driven) tips on how you might think about giving in
general.

------
maxharris
Is there any chance of expanding this to include Americans? Or even better -
people that live near me, such as my zip code + the surrounding zip codes.

That way, there's at least a chance that I'd see the person that I helped
someday.

~~~
tptacek
Worth mentioning that patients in the US, and particularly children, are
guaranteed medical care regardless of ability to pay. Medical care funding can
bankrupt you in the US, but it cannot prevent you from having a broken femur
fixed. States also run "CHIP" programs to provide health insurance coverage to
children.

The same is not true in Haiti or Malawi. Without the funds to pay for care, a
child can live for years --- their entire life, even --- with easily
correctible medical conditions.

~~~
loceng
"guaranteed medical care" - of what quality, with what results? And the value
of medical care being covered is that it doesn't destroy the rest of your
life. It's actually kind of pointless to help someone just get to the point of
surviving, and then leave them to fend for themself.

~~~
philwelch
To me, it's plainly obvious that people in those other countries need our help
more than people in the United States. What other concern is there? "I'd like
to help people in MY country" is just a vaguely nationalistic bigotry.

~~~
tinco
It is not so obvious. There's a lot of suffering going on in your country too.

Charity comes from the heart, and where you should direct your love is your
own choice. If you feel the people in your country are closer to you, there's
no shame in helping them before others. We are human after all.

~~~
philwelch
> If you feel the people in your country are closer to you

That's the nationalistic bigotry I was talking about. That's like saying if
there was a charity that only helped white people, maybe I should contribute
to that because I feel that people of European descent are "closer to me".

~~~
tinco
It is not bigotry, you are misinformed. Black people contributing to
<http://blackcharities.net/> are not bigots, they merely support those whose
fate they identify with.

~~~
philwelch
Sure, people are more likely to help those they identify with. That means
they're more likely to ignore the plight of people they don't identify with.
And that _is_ bigotry. And criticizing a charity for not enabling that is also
bigotry.

------
jmcgough
I really like the transparency - with a lot of nonprofits, I feel like I need
to look into their expenditures to see where my donation is really going and
to figure out if it's worthwhile. Watsi feels a lot more like kickstarter but
directly targeted at helping individual people. Very cool idea.

How do they pay for operations costs - is there a separate donations channel?

------
dasht
Paul Graham, or anyone "in the know", may we please hear a bit about what the
equivalent of a term sheet looks like for a Y Combinator non-profit
investment? Is Y Combinator giving a grant? Is Watsi issuing debt to Y
Combinator? What's the financing model here?

~~~
pg
It's just a donation.

~~~
robg
Have you considered ycombinator.org? Call it a program-related investment and
mirror the .com?

~~~
rdl
One of the things I respect most about pmarca and a16z is that they donate the
difference between real income tax rates and the bogus carry-as-capital-gains
rates to charity (individually or as a firm, I forget).

I wish all VCs would do this, because carry-as-capital-gains is an incredible
abuse of the system. I'm fine with founders getting this, and with LPs who
invest cash, but VCs do not deserve preferential rates over other workers when
they do not themselves take financial risk.

------
Mizza
I used Watsi when it was first announced here. It's a truly amazing offering,
a great product with great customer support and outreach, and, as a user, it
truly makes you feel like you're doing something good for the world.

A few weeks after donating, I later got an email from them letting me know
that the boy whose heart transplant I had funded had died. It kind of wrecked
my whole day, but I was still glad I got the notification. I didn't expect to
have such an emotional connection to a person I have never even interacted
with before. Godspeed, Watsi.

~~~
chaseadam17
Our team was heartbroken to hear the outcome of that treatment as well.
(You've now got three of our team sitting around discussing your incredibly
poignant comment.)

It's certainly a bit of a dilemma, but we've made a promise to be 100%
transparent, even when it hurts.

FWIW we've found ourselves even more dedicated to Watsi since receiving our
first negative outcome. We always knew that what we were doing was real and
important, but there's something about death that really puts the gravity of
the problem we're attempting to solve into perspective.

------
seeingfurther
One could think of this non-profit funding as YC's own charity donation. I
like this type of donation much more than just hard cash. YC is committing
what it does best, building great organizations around amazing teams. I wish
more people, companies and orgs took this approach to donations.

------
rdl
Please figure out a way to take equity eventually (there are organizations
which help non profits do this).

I, and a lot of other startup founders, have limited income to donate, but
potentially have equity which could be worth a lot of money someday. It is a
lot easier to donate equity than current income.

It adds overhead and complicates your "transactional" model, but it might be a
good way to fund your overhead, or to fund longer term projects, and could
eventually be a recurring income stream to pay for some number of treatments.

~~~
chaseadam17
Yes! Great idea. We'll get on this.

------
fghh45sdfhr3
How about a kick starter like nonprofit for social funding of scientific and
medical research?

~~~
kt9
Ask and you shall receive: <https://www.microryza.com/>

~~~
prawks
Very cool! Thanks for the link.

------
jtchang
This is amazing. I love how they are moving so fast they simply publish
results to a Google Doc spreadsheet.

This foreshadows an era where non-profits must aggressively publish their
spending and compete on how lean they become. My guess is there are going to
be a lot of niche sites that perform exactly like Watsi.

------
wave
The only suggestion I have is that it would be nice to see the patient's
profiles get updated after being funded and treatment was given. We all like
to see how our donations are making noticeable difference in people's lives.

I really like what Watsi is doing. They even "eat the credit card processing
fees"

~~~
chaseadam17
Working on this! After Stripe integration, it's one of our top priorities. In
the meantime, you can view every patient update on our transparency document
(see the last
column):[https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...](https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZSaEF1X1JsRm1yZ251d0RQZ0VmRGc&output=html)

------
febeling
Go and fund someone, and observe how a couple of minutes later you get the
notification email that the funding is complete. This is a very powerful new
thing.

------
woodhull
I'm pretty sure that GiveWell (whom I adore) wouldn't like Watsi very much.

It doesn't maximize the utility of donations to spend lots of money saving the
lives of a handful of people vs. other interventions that can save the lives
of many more people suffering from diseases like malaria at a much lower cost
per patient than the interventions that Watsi is promoting.

I think Watsi donors will feel good about helping specific people, but I'm
personally interested in my donations actually being maximally impactful. If
you want to save the most lives per dollar, the sort of extraordinary
treatments that Watsi funds are not a great way to do it.

~~~
chaseadam17
Charitable giving isn't a zero sum game. Instead of taking a piece of the
charitable pie, we're expanding it by offering donors and patients a new
opportunity.

If Watsi didn't exist, many of the patients on our site would have likely
died. How do you quantify that impact? How do you prove that all the donations
made via Watsi would have been allocated to some other cause had we not
existed?

Also, I'd like to say that we really respect GiveWell's work. Quantifying
social impact is a really tough challenge, and it's great to see such an
intelligent team working on the problem.

Furthermore, we actually think they'd be big fans of donations made on Watsi,
at least those made to patients at Nyaya Health, which was rated one of
GiveWell's "Standout Organizations" last year.

~~~
philh
> If Watsi didn't exist, many of the patients on our site would have likely
> died. How do you quantify that impact?

Roughly, by comparing it to the number of people who die in other hypothetical
scenarios. You can't get exact numbers, but you can do a damn sight better
than saying "it can't be done".

> How do you prove that all the donations made via Watsi would have been
> allocated to some other cause had we not existed?

Of course they wouldn't. But what if, instead of creating Watsi, you had put
the same effort into advocating for more efficient charities? (This is a
serious question. I actually wouldn't be completely shocked if it turns out
that that would have been less effective.)

> Nyaya Health, which was rated one of GiveWell's "Standout Organizations"
> last year.

However, they didn't estimate its cost-effectiveness. And on that metric... I
go to your website and see that $1000 can stop someone from maybe becoming
infertile, and that just doesn't seem like it can possibly win against malaria
nets. (Looking deeper, that seems like one of the lowest value treatments
available, but I don't expect the others to win either.)

Don't get me wrong, I'm glad you guys are doing this. I'm not convinced you're
doing the best you possibly could, but you're doing far better than me. I
absolutely think your impact on the world is massively positive. But I don't
anticipate donating to you myself any time soon.

~~~
ichabodcole
I think one thing to keep in mind is whether or not people who donate money
through a system such as Watsi, would have otherwise donated that money to
some other type of organization, and whether by donating through a Watsi like
system they will be more likely to donate to other types organizations in the
future. These questions could definitely use some study (I'll bet there are
some already out there).

Anecdotally, I'm not someone who normally gives to charity, but I gave through
Watsi, because I could see and to some degree feel the real impact of the
money. As a secondary effect, I actually feel more charitable, whether that
means I will give to other types of organizations remains to be seen, but I
would not discount the halo effect systems like Watsi may have.

~~~
dsjoerg
This.

People who are already giving the max to GiveWell-supported charities should
not divert their funds to Watsi.

People who have more to give and want maximum impact should follow GiveWell's
recommendations.

However, many people have not given to the max, nor do they care so much about
maximum impact. For them, there is Watsi to direct their dollars to a noble
cause, rather than on Minecraft-themed plush toys or something.

------
aidos
I just love this. It was featured a few months back and by the time I got to
it everyone had already been sponsored [0]. It's brilliant to see the real
stories of people who's lives you can have a positive effect on right now.

I also use Kiva [1] which is brilliant in a different way. You can loan money
to people so they can fund their businesses etc.

I'm off to donate to Watsi now.

[0] <http://news.ycombinator.com/item?id=4424081> [1] <http://www.kiva.org/>

------
chamboo
This is how all charities should be done. I will be supporting this charity,
and I furthermore think it should be illegal to run a charity in any other
manner than pure transparency. My hat is off to Watsi, and I feel this is a
bigger deal than most people may realize. These are the types of startups we
need to change the world. Not only do they do something good and useful for
people, they also show the rest of the charities that operating with
transparency is the only way to go. Thanks guys, this made my day.

------
orionblastar
Well it is good for people in Nepal.

But what about the USA, especially disabled veterans, people on disability,
people on no or low income, homeless people, and others who cannot afford
their healthcare and got shafted by the federal government?

There are some charities, but they collect funds with Quadriga Art, that keeps
the lion's share of the donations and little to no money goes to the charity
or people in need. CNN has investigated this company
[http://www.cnn.com/2012/09/26/us/senate-charities-
investigat...](http://www.cnn.com/2012/09/26/us/senate-charities-
investigation/index.html) [http://ac360.blogs.cnn.com/2012/09/24/fund-raising-
company-f...](http://ac360.blogs.cnn.com/2012/09/24/fund-raising-company-
faces-new-questions/) [http://ac360.blogs.cnn.com/2012/09/25/charities-in-
debt-to-f...](http://ac360.blogs.cnn.com/2012/09/25/charities-in-debt-to-
fundraising-company/)

This is the reason why so many charities are broke in the USA and the money
never goes to the people it is supposed to help. We can reform this problem by
starting up a non-profit web company to keep the costs low for raising money
for these charities and making sure the people in need get the money and life
saving medical treatments and surgeries that they need.

~~~
jc00ke
Yes, there are people all over that need help, and that definitely includes
those you mentioned in the US. However, there are existing organizations
already working on that, or other organizations yet to be created that could
lead the charge.

Watsi was founded on a few simple principles, and 2 that we apply to every
possible treatment are "low cost, high impact". Unfortunately, health care in
the US is not low cost. It's ridiculous.

I hope one day we can collaborate with an organization or 2 that will take on
the challenge! Until then, there's Give Forward, which does a great job
itself.

------
nsomniact
I lost a bet to a friend. I just used Watsi to fulfill it.

------
ryanmolden
Congrats, this is awesome news! I contributed to a couple of patients when I
first saw you announce this on HN because I like the 'direct to patient, 100%
utilization' nature of it. This is a reminder for me to go back.

I see from your website you are a 501(c)(3) charity. I will submit your
organization for approval for the matching program at my employer, which I
like because it allows me to 'stick it to the man' by donating to all kinds of
things my employer might or might not support (this doesn't fall into that
category though). They also match volunteer hours by employees at $17 bucks an
hour (after the first 10 hours), which can be a great way to get free work and
free money.

~~~
chaseadam17
Awesome! Thank you. Please let us know if we can provide any info for the
matching request: chase@watsi.org.

------
got2surf
After spending the past week thinking about monetizing ads, the next
social/local/mobile app, etc... that all seems so minor compared to Watsi.
It's awesome to see people doing so much social good - best of luck and
amazing job!

------
brezina
Congrats @pg and team! I love seeing YC used for so much good. The impact
continues

------
alpb
Kiva is a similar organization <http://kiva.org> where people can lend money
to people in poor countries for their needs. I wish the same help for Kiva.

------
pratikjhaveri
Just donated. What an awesome cause and an amazing effort by the team. I'm
asking other organizations that I donate to, to follow Watsi's example in
transparency.

------
callmeed
I'm curious if there's a reason Watsi _couldn't or shouldn't_ be a for-profit
company?

I like the fact they're not taking a transaction fee. But, it seems to me that
they're also a benefit to healthcare providers, insurance companies, and big
pharma (after all, the money raised is going to end up in their pockets).
Aren't there ways Watsi could make money from these companies?

~~~
chaseadam17
Great suggestion. We hopefully will make money from them! As a non-profit,
we're able to earn money just as a for-profit would. The only difference is
that we are required by law to invest any profit back into the organization to
ensure we're never personally profiting off of the generosity of others.

------
st0p
I just donated some euro's, and I truely believe those euro's will be well
spend. But it feels wierd (and somehow wrong) to crowdfund someone's health.
I'm not questioning watsi, they are in it for the right reasons. But is
crowdfunding something important as health for poor people the solution?

I think everyone is trying to do good here, but nobody is solving the real
problems.

~~~
chaseadam17
Thanks for the donation, the patient (and we) really appreciate it.

You bring up a really interesting point. Is crowdfunding a sustainable
solution for healthcare? It's something we think about a lot as a team.

Right now, there are people dying for lack of available and relatively cheap
medical treatments, simply because they can't afford them. We think the only
moral thing to do is fund their treatments.

However, is this sustainable? I'd argue that it is for two reasons.

First, the organizations we partner with are all working towards fairly
obvious sustainable solutions. Some establish public-private partnerships,
others cross-subsidize, and others have a very strong focus on training local
doctors (some do all three - we require at least one).

Second, and without getting into a really deep discussion here, only about 40
out of 200 countries in the world have a formal healthcare system. And those
systems that work best are, for the most part, universal healthcare systems
financed by the government (i.e. the costs are crowdfunded via taxes).
However, with the world becoming smaller by the second, is it too crazy to
think that Watsi might one day be the first truly universal healthcare system?

What if instead of a mandatory tax, of which a % is allocated to national
healthcare, human compassion was enough to fuel a global healthcare system?
For the first time in history, the internet is making this feasible. The only
question that remains is whether human compassion is enough to solve one of
the world's greatest challenges.

------
namank
I'm glad.

Not because of the non-profit nature of this startup but the endorsement YC
has now given to non-traditional and perhaps massively big ideas.

------
xfax
Really cool concept, makes donating very compelling. In fact, I just donated
to help fund Esther's treatment.

An idea to get more people to give more - make it competitive. For example,
it'll be cool if I could create a group for my school and then get people to
'tag' their donations with the group ID. Would love to see which school can
get the most donations!

------
toddnessa
A really great idea. I have been befriended by a native pastor in Kenya. His
son came down with something unexpected and had to go to the hospital. The
hospital did not want to let the kid out until he was fully paid up and he
couldn't pay it all . This escalated the bill even further. Something like
this could have really helped.

------
benrmatthews
Amaingly transparent organisation too. You can see every patient they've ever
funded and the outcome of their treatment in a Google spreadsheet, here:

[https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...](https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZSaEF1X1JsRm1yZ251d0RQZ0VmRGc&gid=0)

------
Golobulus
Will there be some kind of illness directory? Or a way I could keep track of
or sign up for notices of new listings? What about a widget that I could embed
on my site for specific kinds of illnesses that readers/users might be
interested in donating to? Congratulations on all of this, really great
idea/implementation.

------
kanamekun
Congrats on a great site, and the exciting news around joining YC! One quick
question:

<< If Watsi didn't exist, many of the patients on our site would have likely
died. >>

If a surgery isn't funding in time to save a patient's life, would you fund
the remaining amount of the loan out of your own funds?

~~~
chaseadam17
Yes, we guarantee funding for all patients on our site by leaving profiles
posted until they are fully funded. Also, we give our partners permission to
pre-treat a patient in the event they need immediate care, so long as we've
already accepted the profile. We then reimburse the partner for the cost of
treatment once the profile is fully funded. In the event we have more profiles
than we can fund (never been the case so far) we will accept and post the
lowest-cost, highest-impact profiles first. However, we can do a pretty good
job of avoiding this situation by growing our partners (and thus our volume of
potential patients) at a rate that corresponds with the speed at which donor
demand is increasing.

~~~
kanamekun
If your doctors do "pre-treat" patients, please be very careful! If patients
are regularly pre-treated, then the 1:1 connection between donor and patient
could be seen as less pure (if the surgery already happened, it isn't 100%
clear that the users' donations funded that specific surgery - as opposed to
just being a general donation to a Medical Partner's operating budget).

A similar criticism was made of Kiva, as covered by the NYT here:
[http://www.nytimes.com/2009/11/09/business/global/09kiva.htm...](http://www.nytimes.com/2009/11/09/business/global/09kiva.html)

It's really important to disclose the date of any surgeries. And if a surgery
has been performed prior to the profile being fully funded (or even prior to
posting), the date of the surgery should be displayed and the profile should
be labeled as pre-treated.

Just want to make sure you guys avoid some of the growing pains of Kiva! (I
used to run Marketing over there for a bunch of 2010/2011.) Good luck!

------
josh2600
This is awesome.

I think this model of achieving more direct distribution through technology
could profitably be applied to a number of for-profit and non-profit
endeavors.

This seems like it could also be a better way of addressing hunger,
contributing food to individuals but using a managed distribution system.

What a cool idea :).

------
vegasje
I'm really glad to see that Watsi got some more attention after their original
HN debut (here: <http://news.ycombinator.com/item?id=4424081>). These guys are
making it so easy to help people in need.

------
zhyder
"I've never been so excited about anything we've funded."

That's great! I'm excited that you're excited. I imagine we'll see a lot more
non-profits in YC shortly. Will 2013 be the year of many such non-profits,
like 2012 was for hardware startups?

------
DannyBee
I'm really glad this is happening. A lot of the traditional funding mechanisms
for non-profits seem badly broken, incentive wise. Then again, i've been in
DC, where I guess almost everything is badly broken.

------
white_devil
Why would a venture capitalist invest in a _non-profit_? Does YC not want a
return on their investment?

------
chunsaker
Way to go, Chase and team. This has tremendous vision and I hope you come out
of YC with a ton of velocity.

------
batemanesque
this could channel money away from preventative care, which is far more cost-
effective than funding later-stage individual treatments. $50 given for the
purchase of malaria nets would save a lot more lives than a single operation.

------
tadruj
A great site for millionaires to visit when they're bored or have lost their
purpose.

------
raheemm
Not to be cynical but how do they ensure the veracity of the patients?

------
zopticity
Wow, I'm really taken away the fact that you're using PayPal. First of all,
you're in YC, where's the brotherly support of using other YC companies? You
got WePay and Stripe, and you're not using either.

~~~
FrojoS
One step after the other. I just donated, despite ever having used PayPal
before, and with a non-american credit card. And - it worked within a few
minutes. I have my objections to PayPal, too, and would like to see
alternatives but that doesn't have to be the focus right now.

~~~
h2s
You're right, and I understand your point, but I would also like to add my
voice to those pressuring Watsi for a PayPal alternative. Personally I had
pressed "Fund Treatment" and was 100% committed to converting until PayPal
loaded. I don't have a PayPal account any more and I won't reopen it for
anybody, not even Watsi.

------
rosstamicah
Next up, a YC L3C (a hybrid for and non profit)

------
theklub
Wow this is a great idea.

------
macorama
Great Job!

------
abraininavat
Really great project. Some thoughts: 1\. In the interest of 100% transparency,
what do you think about being 100% transparent with your tech? Would it make
sense to open-source your technology stack?

2\. I really wish you had the ability to donate on behalf of someone else,
either to fund Watsi or to fund medical treatment. On Amazon I set up a
wishlist that people can easily access for ideas of what to buy me on
Christmas or my birthday. If I could set up something like that on Watsi
instead, I probably would. And if your tech was open source, I might even
implement the feature myself!

