The Story of Bageshwori, Watsi's First Patient | Hacker News Reader

The Story of Bageshwori, Watsi's First Patient

blog.watsi.org

283 pointspg63 comments

I keep a tab open with this image

http://media.tumblr.com/c8a33a98917d46ca8d3220183dfd6e5e/tum...

because I know I'll click on it accidentally a few times a day.

I do it to remind me that there are more important things than whatever fire I'm currently fighting, and also simply because it makes me happy.

As someone who firmly believes in a start-up's social mission, I would recommend getting on phone with a few Watsi clients (I am sure Watsi does it from time to time). It puts perspective on a lot of things.

You are making a lot of impact in these people's lives and they will let you know how much they appreciate it. On a website these people are somewhat distant story but talking to them is when you really share their experience. It will make you feel good (and somewhat worried) about what you are doing.

This is by far my favorite YC company.

My wife and I sponsored a heart surgery for a child in Ethiopia with an organization we work with. The child's mother wouldn't let the child travel to get the needed surgery and that child ended up dying. Tragic.

They used the funds for another child, Kidest, and her photo is on our fridge for the same reason.

In case anyone is wondering, if I am reading their FAQ correctly, they don't actually wait until the crowdsourced treatment is 100% funded before they provide medical care -- per https://watsi.org/faq#am-i-really-funding-medical-care-for-t... .

"Am I really funding medical care for the patient? Yes. Your donation directly covers the cost of care for the patient you choose. Medical Partners provide care to patients accepted by Watsi operating under the guarantee that the cost of care will be paid for by donors. In this sense, Watsi operates much like a traditional health insurance company. When you go to the doctor, your doctor calls your health insurance provider to ensure they’ll cover the cost of care. Your doctor then provides care operating under the guarantee that it will be paid for by the insurance company."

(And thank goodness they don't wait! That would be pretty scary.)

This is a bit different, I think, from the thing people found confusing about Kiva ( http://blogs.cgdev.org/open_book/2009/10/kiva-is-not-quite-w... ) which was that they were inviting investments in microloans which had already been disbursed. But it may be similar enough that you find it interesting if you like to "follow the money".

It's a pretty similar model, but yes with most loans on Kiva, the field partner pre-disburses the loan to the recipient and then lenders backfill the loan. The idea is that this will give field partners some "market" feedback on what kind of loans lenders wish to fund, although obviously there's an education aspect here, because new lenders may not know that some loans may be more impactful at alleviating poverty than others, though either way they are free to choose. As you say, obviously you wouldn't want to do this with medical donations where people's lives are on the line, but it does work pretty well at Kiva I think to provide some inspiration to our field partners to find the most impactful and catalytic loans. That's about 90% of the loans, and then about 10% are post-disbursed only getting funded if Kiva lenders fund them. Then we have Kiva Zip which is true peer-to-peer, for cases when a field partner is not necessary such as working with mobile payments in Kenya or some borrowers here in the U.S. http://zip.kiva.org

With Watsi's 100% of funds going to patients and the fact that they make it so easy to donate, I decided last month to start donating 2% of my monthly income through Watsi. Basically at the start of each month I choose 2 campaigns and donate $50 on each. Is very easy, you should try it.

Whats I find even more interesting is that by end of year I'll donate $1,200. Which turns out to be roughly the amount of 1 life saving surgery in Nepal. So basically I'll save 1 life by the end of the year.

This is so awesome. I'd love to share your story with the rest of the Watsi community. Mind shooting an email to grace@watsi.org so we can connect?

Why split among two campaigns?

I mentioned this before (http://news.ycombinator.com/item?id=4816337), but I haven't seen it implemented and think it's worth repeating:

I love what you guys are doing and hope you can fund hundreds of these at a time. But, right now there's only six people who I can donate to. I want to support the organization as well, to make sure you guys can keep helping people.

How about a "fund our operations" button, or at least some pool that I can donate to if there aren't any people left who need a treatment right this second (as occurred the last time I left this comment).

Otherwise, cheers. I just made another donation. I think what you're doing is spectacular.

I believe the "donate towards our costs" button only shows up when there are no patients to donate to. I have a paypal receipt from donating towards their operating costs, so I know it was up there at some point!

Thanks for the support and suggestions! Since we launched Watsi with 0 funding, it was the ultimate MVP. Because of that, we've had some performance and backend things to fix up before jumping into new features (e.g. until recently our partners were individually emailing us patient profiles).

But we're about to push some new features (Stripe integration, optional "tips" to Watsi, and a General Fund). They're coming soon, we promise! (Teasers below)

Payments & Tips: http://i.imgur.com/ZRzTvhj.jpg General Fund: http://i.imgur.com/fUCM4za.jpg

Awesome! Also, I'm sure you've thought of this, but each profile should be updated when treatment is complete, and you should have a section where these success stories are published. This would lend tremendous credibility to those who look through the funded cases, but don't necessarily click over to the blog.

We totally agree, and we're excited to to integrate updates into the platform as soon as possible. For now, you can view updates (and tons more info) for every patient we've ever funded on our Transparency Google Document: https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...

I think the general fund is the most important option right now. I don't actually want to end up deciding who gets my money, I'd much rather see donations spread out among people who need them, based on medical urgency if possible (as opposed to who is most photogenic or who has the most touching story).

Everyone pictured on the website is guaranteed funding.

https://watsi.org/faq#how-do-the-donation-logistics-work

Everyone wants to change the world, but Watsi changed "her world" and gave her the opportunity to pass it on. If Watsi never makes a dollar ... or even if they never help another soul, it would be sad, but they've left a legacy that few companies can claim regardless of their size.

Well done!

By design, Watsi will never "make a dollar".

As it is operated by a not-for-profit company, never making a dollar is part and parcel of its purpose. Hopefully it also helps many people in the process.

It still makes dollars for its compensated staff and founder/managers (unless the founders are working on a strictly volunteer basis). (PG will not make direct dollars off it, though.)

Incredible, and saddening to think if Watsi was any later this young human being probably wouldn't be around today.

Watsi seems to personalise charity to a level I have never seen before. It's very exciting!

Watsi looks absolutely amazing and I want them to succeed more than any other startup.

Born and raised in Nepal,I ,am so sad and happy at the same time. And thanks 100000x to watsi.org. I know there are many such cases in Nepal and just a little help could save so many human lives in countries like ours. I am a computer science student myself at Silicon Valley, and if there is any technical help necessary for Watsi.org or any such organizations, I am more than ready to volunteer. In the mean time, Thanks again for saving Bageshwori's life.

https://watsi.org/profile/f7523849edfd-kingsley

Done. This is amazing.

Beautiful site and a great way to introduce the concept via Bageshwori. Maybe it's because I'm a parent myself, but I'm still tearing up at these pictures.

I'm donating today, and saving the link for the next person that bitches to me about another Kickstarter delay.

"... I'm still tearing up at these pictures ..."

I agree and was thinking maybe tear-jerker stories on HN should be marked as NSFW. How am I supposed to keep my stoic German personae?

> How am I supposed to keep my stoic German personae?

Slowly pound the desk with your fist as you cry.

I'd like to see them add a "monthly donation" where someone can just set their cc / bank account up to fund $50 a month. They'd allocate the money to specific cases and send you an email to the one(s) they used your money to fund.

This is coming soon - it's one of the top feature requests we get. Thanks for the feedback!

I dont know, but somewhere i think it has an unethical side to it, and i mean donating money for charity as a whole.

Basically people buy themselves peace of conscience by donating a small amount of money that doesnt hurt them to feel good about helping somebody (yay, 2% of my yearly income saved a life!). Then go back to surfing the web on their made-in-china-under-miserable-working-conditions macbook pro. You get the idea, i am guilty of this myself.

I mean of course its a wonderful thing that somehow we can help these people and it has to be done (i do too), but we shouldnt forget that many of these sufferings are symptoms of our excessive lifestyle in the western world.

Sure, but shouldn't the consequence be to do more, instead of less? Not every debt is settled with 100$ / month, but it's a start.

There are some arguments that any charity is doing more harm than good, but I always feel that's a reasoning too cruel to follow.

Kudos to Watsi for doing this. The transparency is the key which is differentiating it from other non-profits and wish them all the best. Even though we know, but it is sometimes hard to keep in mind that for a mere $1200 , you could save someone's life and what it could mean for them. Sometimes, I forget how lucky I am to have sound health, great family and a roof over my head. We take it for granted while millions of people in this world fight every day just to get some of it.

I normally hold the philosophy that a person should not recieve health care unless there is money to pay for them, and I woudn't ever advocate that someone donate to a charity like that. Life is hard and not everybody can make it.

But the smile on her face, especially in that last photo, is really something. And especially at $1125, the chance that she'll contribute more than that back to the global GPD some day is good.

And it might even be enough for me that she might live a normal life.

maybe its time to reconsider some of your philosophy. :)

ayn rand teaches incredible things, but there are big gaps

I hope you never find yourself in a situation where you need medical care and can't pay for it. Because the rest of us, who are in possession of at least a few scraps of human decency, would have to shell out to save your ungrateful ass.

A human life is worth more than its economic output.

Are you familiar with Ramanujan?

https://en.wikipedia.org/wiki/Ramanujan

The importance of someone's life is not correlated to their wealth, or to the environment they're born into. That both factors are used as a metric for who gets to live is shameful.

It is truly outstanding that 100% of the donations reach the medical partners. Watsi is doing it right. Their level of transparency is also admirable.

Nyaya Health, the partner this blog post is about, uses the same funding model, where all donations made are 100% used for patient care in Nepal (unless you explicitly want your donation to be used for US staff/operations)

Bravo to both.

Did anyone else notice that most of the organizations that are facilitating these treatments seem to be Watsi clones, or at least very similar in spirit?

http://amhf.us/, https://secure.cure.org/curekids/donate, http://rickhodes.org/ricks-patients/, http://www.csc.org/donate.php, http://www.nyayahealth.org/donate/

This makes me worry that this is not direct donation, but through one or more layers of brokering.

[Links taken from the transparency document, https://docs.google.com/a/google.com/spreadsheet/pub?key=0Ah...]

From what i can tell, the only "broker" from the list you provided is AMHF. All of the others directly operate clinics and hospitals in various impoverished countries, and directly employ doctors, nurses, pay electricity, buy equipment, etc. AMHF seems to partner with pre-existing health facilities which are in need of funding, which I guess makes them kinda like Watsi, but not really a clone.

Because the IRS requires us to route funds to entities that have an affiliated 501c3, we sometimes have to partner with organizations like AMHF which serve as financial conduits.

However, AMHF and other partners that play this role (Hope For West Africa in Nigeria also does this for a new pilot partner Faith Alive) do not take any cut of donations despite the enormous amount of work they do to help coordinate patient care and manage funds (a huge benefit, since foundations often have more experience with international transfers and disbursement than on-the-ground hospitals do).

Because of this, donating via Watsi is arguably as efficient (and possibly even more efficient from a donor's perspective because we pay the credit card processing fees) as donating to one of our partners directly.

With regard to the the fact that some of our partners also fundraise on a patient-by-patient basis themselves, we think that's awesome! Watsi is proving that truly transparent peer-to-peer giving is better than traditional "Donate Now" forms of giving, and we're ecstatic that our partners are adopting the model. In fact, down the line, we'd like to white label our platform so that partners can feature patients on their sites as easily as they can feature them on Watsi (CURE being the one exception, since they've done a great job of p2p giving or a while now).

Thanks for explaining. Understanding how to efficiently and effectively help is probably one of the most important problems, so kudos for taking a crack at that.

Hey Watsi, you could probably help some folks here in Bangladesh. Let me know if you need any on-the-ground assistance here.

It is awesome to be able to actually see the people you are helping. This literally puts a face on "giving." I like it.

I wish I had a hundred up votes to give! Sitting at my desk at $work, I'm struggling to keep back the tears. You guys are awesome! This is a startup that truly makes a difference. :)

One feature I'd love to see is the ability to setup a regular donation. Doing it via credit card is fine. You can give it to a random person as it makes no difference to me. The option to donate to the operating costs would also be great and then I could do both. The key feature is to make it regular and automatic. In my case, I get paid fortnightly so you could take $25 every two weeks and split it between patients and operating expenses. Will the upcoming Stripe integration allow this?

I love the idea of Watsi, and finally got to donate this time, as the last time I was at the site, every single cause had been fully funded.

My only request of the site would be to make it easier to see the outcome of the patients even for those who haven't funded the procedure for that person. Currently it requires finding the transparency document, and checking the link there for each patient - it might be useful to show more info for the ones that have been fully funded so people know how many people have been treated - that their money is going to make a difference.

There's something I always wondered about 3rd world medicine. If her surgery was $1125 and the average person makes $0.90/day (less than $1) that means her surgery cost 3.42ish year's wages.

Could I get the same surgery here in the USA for $171233 (median income in the US assumed about $50,000)?

Is there some sort of balancing feedback function thats stretching the cost of a certain level of medical care to a certain predictable multiple of a local year's median wage?

It would at least be an interesting rabbit hole to descend.

I would think it would be more complicated given the population difference in the third world vs. the first world.

That would be pretty interesting though.

Great work! I've been working on the philanthropy sector for a few years now. This P2P donation system is very powerful and this particular model can scale very fast. But there are a few traps on the way, I hope I can help you see some of them.

The first trap is the self-sustainability one. See the comments, everyone loves that their money is going 100% to the patient, they are glad they can be 100% sure you are not frauds. But no one cares about how are you going to survive or how much money will you need to be active in 10 years, reaching hundreds times more patients. This, as I see it, is a problem of anchoring. If you are a non-profit, they anchor you on Mother Teresa, you should be a volunteer, have a vow of poverty, be a saint. Anything less than that, you are a simply a fraud, no middle ground, you only deserve the rocks. On the other side, if you a regular startup, aiming for profit, they anchor you on Gordon Gekko, so you just try to be cool and "do no evil" and that's it, they love you. That is the trap also of personalizing the donation. People donate more when they see a face, but then they only care about that face. If you go bankrupt in about a year, they don't care. They only care that THEY saved a life (they did, writing a check, painless, easy, they saved a life with a few clicks, not your hard work, they did) and blame you for not being competent enough. So, the trick is to keep the donation personal and transparent, while raising awareness in donors that your work is relevant (and tough, and expensive).

The other trap, is more a conceptual one. IMO P2P donations are a great tool to connect very different words. When you put a face on it, third world health problems are not just statitics from Gates Foundation reports, they are real problem for real people. This is a great change of empathy level for donors. The trap here is to let that be enough, and fade. As behavioral economics shows, a good action give ones self-indulgence enough to neglect further involvement. It is important to educate people about why this donation is necessary. Explain how big are the health system problems in the country of the patient, explain more about the local conditions of the patient's family, neighborhood, hospital and doctors. Explain why a "cheap" surgery is not already covered. Explain how things might be better in the future, explain how they might be worse. Educate donors so they understand the world we live in. It would be a great service and potentialize the social impact of Watsi.

You guys should try getting ads with patient profiles in public places with a short URL to that profile where someone can donate. It'd be great to see this in places that those TV ad displays that constantly change. I reckon these TV ad spcae providers would be more than happy to donate space. I'm curious how well they would perform to help raise money.

I just donated and was quite impressed with the process. It was painless, no sign up, just direct to Pay Pal. Good job.

Does Watsi do analysis/testing of the blurbs on each patient's solicitations. I notice two distinct themes in the front-page text (before the jump):

* X is sweet, smart, precious, etc

* X has Y condition, that means Z

IMO, stuff like this is unhelpful:

* "The doctor who submitted X case to Watsi describes her as “"

* "X's parents adore her. "

* "to loving parents "

(but tests are better than MO)

Interesting: CURE International, a major Watsi Medical Partner, is an evangelical missionary organization, delivering sermons alongside care: http://cure.org/

This is amazing. One good way Internet is changing lives! Before this, I didn't know about Watsi. But now that I know about difference they make to people's lives, I'll definitely contribute.

This is a great story. That's what you can do with computer science.

A great story on how internet and technology can make a real impact on human lives. Good Luck to Watsi Team.

This is a great program.

I wouldn't want to be the one sorting through the cases deciding who gets treatment and who doesn't.

Just donated and it feels so great.

Thank you, Watsi founders, thank you.

rock on

Any plans to support EBT, to avoid exorbitant credit card fees?

wow, totally awesome. the scene needs more startups like this. congrats guys. this is one of the coolest startups ive seen in a long time.

How does Watsi prevent fraud on the part of Medical Partners (misdiagnosis, not providing treatment, etc), and how can donors feel confident that Watsi's controls are effective?

Ever since I donated to Watsi I've been getting paper mail from other charity organizations making pleas for me to donate money to them.

Has anyone else had this experience?

Wonderful story.

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