Good morning, Hank, it's Tuesday. Exactly 15 years ago, I was making my second ever Vlogbrothers video, and today I get to announce what is, in my opinion at least, the most amazing thing that has ever happened in this little 15-year-old corner of the internet.

So back in 2019, our family made a long-term commitment to support Partners in Health's efforts to radically reduce maternal mortality in Sierra Leone's Kono District, where, at the time, 1 in 17 women died in pregnancy or childbirth. But we couldn't do this anywhere near alone, because Partners in Health needed $25 million to fund the building, supplying, supporting, and staffing of the maternal care center and NICU at Koidu Government Hospital, which is the only hospital serving the 500,000 people of Kono.

Even before COVID, raising $25 million felt somewhere between, like, ambitious and impossible, but we felt like it was worth reaching for, because we knew it could transform the kind of care available in the region, and also because it would serve as a teaching hospital that could train the next generation of Sierra Leonean midwives, nurses, and doctors.

Since then, thousands of you have become monthly donors to this project, and hundreds more people have banded together to form a matching fund to ensure that every dollar donated monthly gets matched. And combined with fundraising from PIH and support from projects like Life's Library and the Awesome Socks Club, ground has broken on the Maternal Center of Excellence. It is on track to open in 2023, and we - champagne pop - are on track to raise over $25 million.

Can you drink on YouTube? You can. Mm, ah, it's a little early for champagne. Brief camera 2 side note - when I say "on track to raise," I mean assuming donations continue at about the same monthly level that they're currently at, so if you're giving now and you can afford to keep doing so, thank you, and your support remains critical. If, like me, you're interested in the details of how the money is being raised and how it's being accounted, there is an unlisted livestream in the doobly-doo. Okay, back to camera 1.

We are a large community, but not that large, and that we've reached such an ambitious fundraising target faster than even our rosiest projections is a real testament to what communities like Nerdfighteria can accomplish. And in a time when so much is so terrible, I am really heartened by the generosity and solidarity I have seen in the last two years.

And it's working. Even as the MCOE is under construction, the healthcare system in Kono is getting stronger. Fewer mothers are dying for want of an emergency C-section, and more kids are surviving. Maternal mortality is still hundreds of times higher in Sierra Leone than it ought to be, but it is getting better, and child mortality is decreasing dramatically. In 2021 alone, Koidu Government Hospital saw a 36% reduction in child mortality at its pediatric ward.

I sometimes worry, though, that those statistics can obscure the hundreds of human stories they contain, so here's one story. This is Emma, who, until recently, was a normal 13-year-old in Kono. She and her twin sister, Katie, do well in school. They're both into soccer. They both love pop music.

But Emma often felt unwell over the last couple years, which slowed her down in school, and then, one day, she had a seizure, so her family took her to Koidu Government Hospital, where the care team suspected malaria, so she got some medication and went home and initially felt better but then returned to the hospital very critically ill.

After every other test came back negative, Emma was driven five hours to one of the only CT scanners in Sierra Leone, where it was revealed that she had meningitis caused by tuberculosis in her brain. Her condition required five months of treatment in the hospital, but she recovered, and now, inspired by the nurses who took care of her, both Emma and Katie want to become nurses.

Now, there are many ways to think about Emma's story. One is that, because the healthcare system in Kono is getting stronger, she survived. Another is that, if she had lived in a region where CT scanning is widely available, she never would have become so sick. And another is that many kids in Kono are dying in the same situation, because the hospital is too far away and too expensive to get to.

So you could think of the healthcare system in Kono as a wheel, where the hub is Koidu Government Hospital, which is surrounded by primary healthcare centers where people should be able to get care for everyday ailments and access basic treatments and medicine. These clinics also need to have safe, clean, well-staffed spaces for delivering babies, and they need to have staff trained to identify serious illnesses, like Emma's, or serious pregnancy complications, and there has to be a system in place to refer those emergencies to the hospital and transportation to get them there. As we learned at the very beginning of this project, long-term systemic problems demand long-term systemic solutions.

When Sarah and I visited Kono in 2019, we spent some time in a primary healthcare center in the town of Kombayendeh, and the clinic was not really functioning. There was no running water, no electricity, no paid staff. There was a cold storage system for vaccines, but that was about it, and so the only actual healthcare we saw that day was a mother getting her child vaccinated. The place was otherwise empty, because why would you use a healthcare system that can't provide healthcare?

Thanks to support from PIH donors and the Sierra Leonean Ministry of Health, the clinic in Kombayendeh recently celebrated major improvements. There is now a safe, well-stocked pharmacy, running water, a laboratory, training and mentorship for clinicians, and there are patients, which is one way you see the success. Like, in the town of Sewafe, the primary healthcare center there saw 5,000 patients in 2020, but then, because of big improvements to the clinic made by local health leaders and Partners in Health, the clinic in Sewafe is now a place where you can deliver babies safely and get good care, and as a result, in 2021, it saw over 20,000 patients.

Okay, so when Hank and I found out that we were on track to reach this $25 million goal, we asked PIH Sierra Leone what else they needed, and they answered, "First, we wanna make the MCOE a better teaching hospital, with dedicated classrooms and a 100-bed dormitory, to better support training of the next generation of maternal and childcare professionals" - perhaps, who knows, even including Emma and Katie. They also want an outpatient department at the Maternal Center of Excellence that can provide maternal HIV support and family planning, and they want to build a first-class warehouse to store and manage medications and supplies.

Lastly, they wanna support a primary healthcare clinic in the town of Kaima, where the clinic currently looks like the one in Kombayendeh did back in 2019. In the dry season, there is no running water. Nighttime electricity is rare. The pharmacy is inadequate and so are the facilities for delivering babies. What do I mean by inadequate? I mean this is the only bed for laboring mothers in a city of 90,000 people.

And the lack of water and electricity is a huge problem, as the facility's Chief Health Officer, Ibrahim Rogers, put it. "My first challenge is water. Every inch of our work needs water." Right now, without running water, the water to wash hands and instruments is stored in buckets that healthcare workers have to refill throughout the day by walking to the city's tap. As for electricity, a traditional birth attendant at the clinic explained that, without it, she often has to hold a flashlight while other team members attempt to deliver a baby in darkness.

These conditions dramatically increase the risks for both mother and child, and it simply doesn't have to be this way. The best clinic in Kono, the PIH-supported Wellbody Clinic, has the stuff, space, staff, systems, and support to provide good maternal and child care, and as a result, there hasn't been a maternal death at Wellbody in over a year. And we hope that someday soon we can say the same for the clinic in Kaima.

To help make that happen, our family is increasing our personal commitment to Partners in Health by $2 million over the next four years, and we're hoping to raise an additional $4 million in that time to take the total value of this project from $25 million to $31 million. That'll be enough to get some support to the clinic in Kaima and expand what the Maternal Center of Excellence can be.

Now, some of that $4 million will come from projects like Pizzamas, but by far the most efficient way to support a stronger healthcare system in Kono is by becoming a monthly or one-time donor to this project at PIH.org/HankAndJohn.

Lastly, there are way too many people to thank, from PIH Sierra Leone's Executive Director Dr. Bailor Barrie to the Maternal Health Lead Isata Dumbaya to everyone at DFTBA.com, but I wanna say a special thank you to everyone who has donated to this project, from $5 gifts from 10-year-olds to a $500,000 gift from YouTube CEO Susan Wojcicki. We got here the only way people get anywhere good: together.

And whether you can afford to give or not, thank you for following this project and for sharing it with your friends and family. Your attention is also a gift, and a critical one. One more time, the link is PIH.org/HankAndJohn, link in the doobly doo. Someone go back to 2007 and tell this doofus that the community building up around Vlogbrothers will one day help fund a Maternal Center of Excellence and NICU.

Thank you so much. If I've learned one thing from 15 years on YouTube, it's this: Never underestimate Nerdfighteria. Hank, I'll see you on Friday.