Good morning, Hank. It's Tuesday. So, listen. I have some very good news amid, uh, gestures broadly.

Back in 2019, when I was young and promising, I said, "Systemic, long-term problems demand systemic, long-term solutions." And today, Hank, we get to see some of the ways that long-term, sustained, open-ended attention and resources can mean long-term change for the better.

In that video back in 2019, I was announcing that our family was donating $6.5 million to support the building and maintenance of a maternal and infant care center at Koidu Government Hospital in Sierra Leone. At the time, the most recent statistics indicated that one out of every 17 women in Sierra Leone was dying in pregnancy or childbirth. But that $6.5 million wasn't nearly enough to build this Maternal Center of Excellence in the Kono District. We needed $20 million just to break ground.

Fortunately, thousands of you became monthly donors to this project at PIH.org/HankAndJohn. Dozens of you came together to build a matching fund so that every dollar donated monthly could be matched. And Hank, the folks at Good.Store also helped out with the Awesome Socks Club and Sun Basin Soap, which together have raised $10 million for this project.

So, if you've donated directly through PIH.org/HankAndJohn or you've bought socks or soap, thank you. And if you're in the market for socks or soap that literally save lives while also keeping your feet warm and cleaning your body, check out Good.Store.

But anyway, with all those efforts combined, we raised that $20 million and then some. And now, six years on from that first video, the world is very different.

The maternal mortality rate in Sierra Leone, thanks to a huge effort from the government and from organizations like Partners In Health, is no longer one in 17. Now, the lifetime risk of dying in pregnancy or childbirth is around one in 74, which is still much too high, of course, but it does mean an over 60% reduction in maternal mortality just in the last several years.

To me, this is a reminder that when we pay attention to a crisis and focus resources on that crisis, change can happen. The world can get better.

So, why have we seen such a dramatic reduction in maternal mortality? Well, I would say it was simple, but it's not. Because to properly serve babies and new moms, the whole health care system needs to get stronger.

We need ambulances so that people who need an emergency C-section don't have to get on the back of a motorbike. We need primary care clinics that can be safe places to deliver most babies. We need community health workers who can identify high-risk pregnancies in their own neighborhoods. And we need the Maternal Center of Excellence, a high-quality clinical facility on the campus of Koidu Government Hospital that can deliver care to babies and new moms.

A lot of this system strengthening has been happening throughout the last six years. More nursing students and residents are studying at KGH as it became a teaching hospital. More community health workers have been added, and so on.

But the capstone project, this Maternal Center of Excellence, with 120 hospital beds, operating rooms for safe emergency C-sections, and a huge blood bank and NICU, has remained a dream until now.

Today, I get to tell you that the Maternal Center of Excellence will complete construction in October, and after a period of intensive training and refinement of protocols, it will begin to open to patients in January. They'll begin with inpatient care and then, in a phased approach, include more and more outpatients. This teaching facility is going to become a reality, dramatically improving the kind of care available to babies and moms in eastern Sierra Leone.

Now, I want to be clear about a couple of things, Hank.

First off, this facility would not exist without Nerdfighteria. We've raised the literal majority of funds needed to make this place a reality, but it also wouldn't exist without the financial and systemic support of the Sierra Leonean Ministry of Health. PIH is not trying to create a parallel health care system or whatever. This facility belongs to the people of Sierra Leone through their government.

Also, it couldn't have happened without many other donors to Partners In Health. And it couldn't have happened without the construction staff, most of them women from the Kono District, who have learned new skills and worked incredibly hard to make this place a reality.

In short, this has been a huge collaboration.

And secondly, it needs to continue being a huge collaboration. We need your ongoing support for the MCOE because its funding needs do not end with the completion of the building's construction. This will be a world-class training facility that strengthens and supports Sierra Leone's health care workforce. It will provide care to thousands or tens of thousands of people every year. And it will radically reduce maternal and infant mortality in Kono and beyond.

But to do this, we need to provide ongoing support because, as I said in 2019, long-term systemic problems demand long-term systemic responses.

And so, if you're able to give to this project or are already giving to it, thank you. But Hank, this is happening. Sierra Leone is a vastly safer place to give birth than it was in 2019.

And while Nerdfighteria certainly isn't the main character of that story, we have played a role. I think, in many ways, we can cite this as the greatest accomplishment in the 18-year history of this strange and lovely little YouTube channel.

But this can't be the end of the story because, in many ways, the opening of the MCOE is the beginning of the story of people in Kono being able to access the kind of high-quality, dignified care that every human being deserves.

And so the truth is, we need your support now more than ever. And I don't just mean donating at PIH.org/HankAndJohn or buying socks or soap. I also mean donating your attention, because we solve the problems we pay attention to.

And we are starting to see how long-term, open-ended attention really can address long-term crises—from one in 17 to one in 74.

And we're just getting started.

Hank, I'll see you on Friday.