HOW started humbly in 1992, offering a resource library to women with cancer on the outer Cape — Eastham, Wellfleet, Truro and Provincetown. The economy, based on seasonal tourism and a declining fishing industry, meant that many were low-income and lacked health insurance. Geographic remoteness meant weak public transportation. Severe illness, especially for elderly single women, was extremely hard to manage. The needs were so great that by 1994 HOW had expanded its reach to women of all ages diagnosed with any chronic or life-threatening illness, and it provided anything that might help: access to preventive exams and services; weekly support groups; stipends for health services, heat or electricity; companionship and family respite visits; and transportation to Hyannis and Boston for doctor and hospital visits. HOW had to grow; last year it served over 164 clients, some in multiple programs, funded at a very modest level from meager local sources — town programs and foundations, private donations, and fundraising events (an auction, a “By the Sea Bike Trek”). How would you like to be an angel, and just send these folks an unsolicited check out of the blue?