Making Medical Care Affordable In Developing Countries, With Help From The Crowd

Medical care is never cheap, and it’s an especially big burden in developing countries. Watsi harnesses the crowd to change that.

Chase Adam was a Peace Corps volunteer in Costa Rica in 2010 when a bus ride changed his life. "I was coming back from San Jose, and this woman got on the bus," Adam remembers. "Usually people are selling something, or they’re preaching something about religion. But everybody was giving her money, and I couldn’t figure out why." As the woman got closer, Adam realized she was carrying her son’s medical records, collecting money for his treatment. "That was the lightning moment," he says. Thanks to his background in microfinance, Adam was familiar with Kiva, where they’ve used crowdfunding to provide millions of dollars in microloans to business owners in developing countries. "Why can’t we do Kiva for health care?" he wondered.

On August 23, Adam officially launched the medical crowdfunding platform Watsi.org, named for the town where the woman got on the bus. The kickoff comes after a year and a half of work with an all-volunteer team (including his two closest friends from the Peace Corps) as well a successful pilot program in which they crowdfunded heart surgery for a young Nepali girl named Bageshwori…in two days. Bageshwori’s story is posted on the Watsi website, along with her photo and a link to the medical partner responsible for her care; there are profiles for the 17 other patients whose treatments have been funded thus far, too. There’s also an impressively transparent FAQ intended to let donors know where every dime of their money is going. It’s like the web version of those "for just the price of a cup of coffee a day…" TV commercials, except there’s zero room for doubt.

Adam says making a personal connection between donor and cause is an important part of his vision. "The inspiration for Watsi was that day on the bus," he says. "But the motivation was to create an organization that I would want to donate to." He calls his past experience donating to prominent nonprofits "terrible," explaining, "I had no idea where my money went. It wasn’t that I distrust those organizations, I just figured maybe my couple hundred bucks went to pay for an office in Washington D.C. or something. I like microfinance because it’s having an effect on the ground, as opposed to a lot of large-scale NGOs where it’s really difficult to measure social impact. It’s hard to put a face with a statistic."

Another hallmark of Watsi’s plan is the limited number of patients in need they’ll feature at any given moment. Unlike Kiva, for example, where the thousands of opportunities may prove overwhelming to some donors, the Watsi team intends to focus on a handful of stories at a time. "Right now, I trust our medical partners one hundred percent," says Adam. "We have these personal relationships with them, and it’s been fantastic. Our internal motto is, ‘We’d rather be sold out than sell out.’ We’d rather not have any profiles up than ever take a chance with someone we don’t trust." Currently, they’re funding patients from just three partners: Nyaya Health, a tiny rural clinic in Nepal; Wuqu’ Kawoq, an organization providing health care to indigenous peoples in Guatemala; and Dr. Rick Hodes, who directs the JDC’s medical programs in Ethiopia.

Watsi’s launch inspired a flood of interest—a savvy decision to post the URL on Hacker News netted them 20,000 unique views in the first 24 hours alone—and scores of volunteers have since reached out to offer tech help. Adam seems legitimately blown away by the attention they’re receiving, but admits the one thing the Watsi team doesn’t quite have sorted out yet is how to quit their day jobs.

"In all honesty, we love working together," Adam says of his volunteer squad, currently spread across several time zones and continents. "We go on a Google Hangout every Tuesday, and it’s been a great experience. But I think that if we really want to have the impact we believe that we can have, we’re going to have to do this full time. So now it’s just a question of where that funding is going to come from." Along with the usual grant-writing and high-net-worth-individual options, they’re considering implementing a feature where donors could leave a tip for the folks behind the curtain.

Meanwhile, they’ll just keep putting new patient profiles on the site, and hoping people pitch in. So far, that hasn’t been a problem, and Adam thinks he knows why. "I work with nonprofits, but I hate asking for money," he admits. "What I think is special about Watsi is it’s one of the first nonprofits where we never have to. We’ll just show real life. It’s authentic. If you feel compelled to donate, you donate. And if you don’t, you don’t. But I think it’s cool that the model speaks to people."

Add New Comment


  • aram harrow

    It seems unfortunate to encourage people to donate based on a compelling story rather than on trying to help as many people as they can with the money they have (e.g. as givewill.org attempts to do).  Best practices for donors are generally NOT to earmark money, because if you don't trust an organization to spend it in a cost-effective way, then you shouldn't trust it to spend it on an earmarked project.  In this case, it seems that the patients funded are specifically ones whose treatment is not cost effective enough to be a priority of existing NGOs.  But then why would those NGOs solicit donations for this treatment and then implement it?  It seems the only rationale for the NGO is to draw in new donors, who otherwise wouldn't give anything.  This seems dangerous: it risks a backlash once people start to understand what's going on, and it risks teaching them the wrong lesson about funding overhead costs.

  • Carolinebeaumont

    Ok great initiative, but kind of ironic that Adam's own misgivings about charities using donations to pay for the backroom stuff is preventing him from going at it full time and scaling up. . .get over it, pay yourself a fair salary and be upfront to your supporters about why you need it.

  • Nijustha

    I am from Nepal. Could you please provide more details about Nyaya Health?
    Great Job Indeed!!

  • Jscherm

    I can't help but wonder which patients receive the most donations. The kids? People who are worse off, or people with nice smiles? I understand the principle, but there's something of a creep factor here.

  • Chase Adam

    Thanks for your comment Jscherm. We know where you are coming from, and we understand that it can be overwhelming to decide who to help when it appears that there are so many people in need. But, I'd like to point out a few things:

    1) We only post profiles until they are fully funded, so there is never a risk that a patient won't receive treatment because they "don't have a nice smile."

    2) All profiles we post are approved by a minimum of two doctors, and "being a kid" or "having a nice smile" isn't a criteria these doctors use when making a medical decision. Instead they ask, "which treatments are likely to have the greatest impact for the lowest cost?"

    3) Who you fund depends on you. If you'd like to fund treatment for a patient that you don't think other people will support, we hope you will put your beliefs into action by helping to fund that profile.

    4) We realize that sometimes people have a difficult time deciding what treatment to fund. For that reason, we are working on a new feature that will enable people to donate to a general fund that supports multiple patients. Is this something you would consider giving to? 

    Life isn't fair. We think it sucks that millions of people die each year as a result of illnesses that are treatable. And we understand that exposing this reality makes some people uncomfortable. But that isn't our goal. Our goal is to offer people a direct, personal and tangible way to help. If you have any questions, or suggestions for how to improve the platform, we'd love to speak with you. Feel free to reach out to me at chase (at) watsi (dot) org.