Could someone ELI5 what that actually does and how one would use it?
It combines outgoing (SMTP) and incoming (POP, *MAP) functionality, so it would be like using Dovecot and Postfix (rival mail server products) together.
It requires that you have a relational database (the documents describe MySql) and a key-value store (the documents describe Memcache) to support it and the documentation suggests it's designed for Linux (specifically with instructions for CentOS, which is a Red Hat distro). A mail server is generally installed on an "always-on" computer connected to the internet-connected network.
Note that even though it's "designed with security in mind", I don't see any mention of a security audit on either the linked page or the GitHub repo.