Category Archives: Italia

Stairway of Lawfulness

A primary school in Acerra, Italy, near Naples, has written, in large letters and on a background of bold colors, the names of victims of the Mafia on its front steps — including judges who knowingly put their lives at risk — so that every day the students will be forcibly reminded of the importance of combating lawlessness with justice.

On the first step, among all the Italian names, one is American: Nicholas Green. 

Stairway - Italian school

Photo by ‘Ansa’ press agency, Italy

Link to Ansa article: https://www.ansa.it/campania/notizie/comune_di_acerra/2023/03/21/inaugurata-scala-legalita-al-iv-circolo-didattico_605bddc1-da82-4502-b9d0-0b816b23ab6e.html

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BBC News. Organ donation: ‘My daughter was shot but lives on in those she saved’

By Harry Low (BBC News reporter)

After the fatal shooting of a six-year-old girl in India last year, her parents made a choice few in the country do – donating her organs. Despite being expected to surpass China this year as the world’s most populous nation, India is 62nd in the global donation league table. The BBC travelled to Rome, where a campaign sparked three decades ago by another child’s gun death could show how progress can be made.

Link to the complete article: https://www.bbc.com/news/world-asia-india-62987703

BBC Article - Harry Low - January 2023

Rolly Prajapati was sleeping peacefully last April in the home she shared with her five brothers and sisters in suburban Delhi. In the next room, her parents were preparing dinner when they heard a loud bang and a scream.

When they went into the room, Rolly cried out for her parents before falling unconscious. […..]

After days of agonising, her parents made a decision few in India have done before: to donate her organs. Rolly became the youngest donor at the All India Institute of Medical Sciences (AIIMS) in New Delhi. […..]

“Eventually we decided to go ahead, thinking ‘if my daughter’s organs could save someone’s life, then we should do it’. “We think that our daughter is alive inside the young recipients – our daughter will live on this way.”

Both of Rolly’s kidneys were transplanted to Dev Upadhyaya, 14, whose parents told the BBC it was “a miracle to us” that he received the organs. They had been waiting four years for a transplant and said their “life has been changed” because Rolly’s kidneys had “given new life” to Dev. […..]

Rolly’s death has parallels with the story of Nicholas Green.

The seven-year-old was on holiday in Italy with his family in September 1994 when the car he was travelling in was shot at in a suspected case of mistaken identity.

His parents, Maggie and Reg, made the decision to donate Nicholas’s organs. Reg has dedicated much of his life since to a campaign to encourage more organ donation. […..]

L’effetto Nicholas – the Nicholas effect – is clear to see. The hope is that a similar transformation will take place in India.

At the forefront of this is Dr Deepak Gupta, who has travelled to Rome to meet Reg and other experts from the organ donation community. It was Dr Gupta who first spoke about the option of organ donation to Rolly’s parents – they, like many in the country, had never heard of it. He used Nicholas’s example to show Mr Prajapati, the possible impact of donating. One person dies in India from a head injury every three minutes, according to the Lancet Neurology Commission, and so, Dr Gupta says, there is “a lot of potential for donors”

BBC Article - Harry Low - January 2023 - 3

Each time Reg, 94, returns to Italy from his home in Los Angeles, he meets some of Nicholas’s recipients – on this trip, he met two women bound together by the transformative effect of donation.

Shana Parisella’s brother Davide was killed in a car crash in March 2013, and his heart was transplanted to Anna Iaquinta. Nine years after the operation, Anna decided to search for her donor’s family and formed a strong bond with Shana, who she says is like a sister to her.

Shana, who has driven 140 km. from Fondi to Rome, said it was a dream to meet a “great man” who was “an example for everyone”.

Anna said: “It’s not easy for the person that receives the heart because you have a lot of thoughts and you kind of feel bad because on their side there’s a lot of pain. But on your side there’s a lot of joy, so it’s kind of like two different emotions.” […..] “Nothing will ever be enough for having received life.” […..]

After visiting Rome, Reg travelled to Messina where he met 24-year-old Nicholas, the son of Maria Pia Pedala who was in a coma when she received Nicholas’s liver 29 years ago. He says he will only stop speaking about the issue when he dies. “I’m 94 years old so I was quite old when I started this,” he told the BBC.

“I think by now I would have hung up my tonsils but the thought that just by talking you can save lives has been a thought that motivates me every day.”

 

Link to the complete article: https://www.bbc.com/news/world-asia-india-62987703

Twitter BBC: https://twitter.com/BBCWorld/status/1620237444250468352

Twitter Harry Low: https://twitter.com/harrylow49/status/1620924625957060608 

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In the news: “Transplants, that gift from Nicholas’ and Rolly’s parents that saved lives” (from ‘Il Corriere della Sera’)

Author: Maria Giovanna Faiella.

Date: September 30, 2022

The stories of children, struck by a tragic fate, will be told where organ donation is almost non-existent. In Italy, 28% still oppose donations.

The story shook the conscience of Italians. Nicholas Green, the 7-year-old American boy on vacation in Italy with his family, was shot to death from a bullet on the Salerno Reggio Calabria highway, 28 years ago: thanks to his parents decision to donate his organs and corneas, five people were saved and sight was restored to two others. The gesture prompted many compatriots to follow the example of the Greens: donations, therefore transplants, increased and lives were saved.

Last April, Rolly Prajapati, a six-year-old Indian girl, was killed in a shooting: her parents also decided to donate organs. Nicholas’ and Rolly’s families have turned their personal tragedy into a generous act of solidarity with people, unknown to them, waiting for a new organ. Now, with a new campaign to increase organ donation which starts in Messina on October 1st, the hope is that the Nicholas effect will be repeated in the poorest countries in the world — but also in developed ones, including Italy, where every day someone on the waiting list dies.

Rome press conference

The speakers of the press conference

Love for Italy reciprocated

Reginald Green, Nicholas’ father, returned to Italy to support the new campaign: it will start on the same date (October 1) and in the same hospital where Nicholas died; this time the story of a little Indian girl will help tell the world that what distinguishes the life of an organ donor is not the sudden calamity that caused his death, but the new life that it has generated, and the hope of a better world that follows. Nicholas – remembers moved Reginald Green, now 93 – loved Italy and although he was only seven, we had already brought him here three times. “Since his death, Italy has repaid that love of him many times, including over a hundred places named after him. Even more, the love of Italy was revealed in a practical way: in the ten years following his death, organ donation rates tripled. Understanding the strength of that reaction is crucial to our new campaign which will be similar to the one that focused on Nicholas and which was so successful in Italy, but this time it will include Rolly. We will tell their stories in places in the world where organ donation is almost non-existent and where, every year, hundreds of thousands of people die while they could be saved by transplanting new organs if they were donated.”

Replicate the Nicholas effect

With the pandemic, donation rates have dropped around the world – explains Professor Deepak Gupta, a neurosurgeon at the All India Institute of Medical Sciences in New Delhi, who coordinated Rolly Prajapati’s organ donation. In India, where organ donations are very few and pediatric ones are almost unknown, thanks to the media attention for the story of Rolly, whose organs have saved other children, donations increased from April to August by over 60%. The hope is that the Nicholas Effect – which has driven the increase in donations in Italy – will be repeated in the poorest countries in the world but also in the areas lagging behind with donations, including some Italian regions.

There are those who still oppose it

“In Italy, at the beginning of the pandemic there was a decline in donations and transplants. Last year there was a recovery, with an increase of more than 10 percent compared to 2020, and donations also increased by 6%”, says Letizia Lombardini, medical director of the National Transplant Center. In our country too, the availability of donated organs is still lower than needed. “Last year there were over 8,000 people on the waiting list for a transplant”, Lombardini reports. In our country, the opposition rate to donations averaged 28 percent. In addition to the refusal to remove the organs made by the relatives of the deceased person, they also registered too many “no” responses to donation at the time of issue or renewal of the identity card. Dr. Lombardini reports: “In 2021, out of 5 million Italians who renewed their identity cards, 3 million expressed their willingness to donate organs, several said “no”, others still did not express themselves.”

International conference

The organ donation awareness campaign starts in Messina where the first edition of the International Conference will be held on 1 and 2 October (DONARTE 2022 – DOnation and Art: Nicholas And Rolly Testimonials.)
“Sicily is at the bottom of the national donor ranking. There are just 11 donors per million inhabitants (compared to a national average of 24), while the opposition rate (people opposing donation) is over 40 percent” – the director of the anesthesia complex operating unit of the “Martino” Polyclinic of Messina, Anna Teresa Mazzeo said. “The awareness of citizens is fundamental, which must go hand in hand with the training of health personnel”.

Originally published in “Il Corriere della Sera” newspaper. Link: https://www.corriere.it/salute/22_settembre_30/trapianti-dono-genitori-piccoli-nicholas-green-rolly-prajapati-04b36fa4-4096-11ed-8b65-55aa2f703574.shtml

This English version is adapted from: https://time.news/transplants-that-gift-from-nicholas-and-rollys-parents-that-saved-lives-time-news/

 

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Organ Donations Set a Record at India’s Biggest Hospital

    In April of this year Dr. Deepak Gupta, professor of neurosurgery at the All-India Institute of Medical Sciences (AIIMS) Delhi, coordinated the organ donation of a six-year old girl, Rolly Prajapati, who was shot while sleeping next to her parents at her home in Noida. The circumstances were close to the shooting of my own seven-year old son, Nicholas Green, while we were on a family holiday in Italy from our home in California. In the following 10 years organ donation rates in Italy tripled, a phenomenon that is known there as “the Nicholas Effect.” (nicholasgreen.org)

Donarte 2022

From left to right: Dr. Antonio David (Dean of Messina University), Dr. Deepak Gupta, Reg Green and Dr. Anna Teresa Mazzeo at Donarte Conference, Messina, October 2022

    A striking change has shown itself in India too. Since Rolly’s death, the number of organ donations at AIIMS Delhi has risen to 13, higher in those five months than for any full year since the transplant program there began in 1994. The 3,200 bed hospital usually has five to eight donations in a full year.

    The donations since Rolly’s death have yielded 43 life-saving organs and 26 tissues, such as corneas to restore sight and heart valves to cure children born with congenital heart diseases. One of the donations was from the youngest child ever transplanted in India. This rapid rise is already being talked about as “the Rolly Effect.”

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Maria Pia, Dying at 19, Is Now a Radiant 47-Year Old

She is 47, lives in Sicily and likes true stories with happy endings. That’s understandable. She was on her deathbed when she was 19.

Her name is Maria Pia Pedala and she was saved from a seemingly inevitable death by a liver transplant. When I met her a few months later she already looked full of good health. Her way back continued so well that in two years she married her loyal sweetheart, Salvatore, and four years after the transplant had a baby boy and two years after that a girl, two whole lives that would never have been.

Maria Pia Pedalà and Reg Green

Maria Pia Pedalà and Reg Green at Donarte Conference, October 2022. Photo by Andrea Scarabelli

     All this was a long time ago — she received her new liver in 1994 — but recently, back in Sicily for a few days, I chatted with her just before she gave a speech promoting organ donation at Donarte 2022, an international conference on transplantation at the University of Messina, and I could see in her the prototype of a busy matronly housewife, who gets up by 5.30 am daily, keeps the house clean and tidy, gardens, cooks and deals with all the other needs of a loving family.

She watches her health carefully, goes to bed early, eats sensibly and takes her medications meticulously, feeling she has an obligation to both the healthcare staff who have kept watch over her from her teenage to middle years and to the family who saved her life.

The result is she can do everything normal people of her age can do and in a line-up no one would pick her out as the one who had been the sickest. She also finds a preciousness in the small things in life that eludes most people.

Transplantation is a medical miracle and, even though it is an everyday procedure in hospitals all over the world, it doesn’t stop being a miracle that physicians can take a body part of someone who has died, put it into the body of someone who is dying and bring out of it a healthy person.

In this case, for my family, the story has an element in it that takes it to a higher level still: our son was her donor.

Author:  Reg Green

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Twenty-eight Years Later: Where Are Nicholas’ Killers?

A newspaper in Italy recently asked how we felt about how Nicholas’ killers were treated.

This is what we said:

We never wanted revenge, only what the law prescribed. The one who drove the car was given 20 years in prison so he served the prescribed sentence and was then released. The one who fired the shot was sentenced to life imprisonment but became a ‘pentito’ (that is, he cooperated with the police and supplied information to clear up other crimes) and has had a good enough life under house arrest to have fathered two children. I have to leave it to Italians to decide if that is sufficient punishment for taking the life of an innocent child.

Reg Green

Corte di Cassazione - Roma

The “Corte di Cassazione”, ‘Supreme Court of Cassation’, in Rome (Source: Wikimedia)

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From “La Stampa” Italian newspaper

“La Stampa”, a national Italian newspaper edited in Turin, just published the article “Organ Donation Group Comforts Families Who Didn’t Donate” by Reg Green, on Friday 15th.

La stampa article - July 15 2022

Article title: “Another beautiful deed after 28 years”

Link to the article in English in this blog: https://nicholaseffect.org/2022/07/01/organ-donation-group-comforts-families-who-didnt-donate/

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Organ Donation Group Comforts Families Who Didn’t Donate 

The Aido division for the Province of Alessandria (a volunteer group in the Piedmont region of Northern Italy, alessandria.provincia@aido.it) and the Alessandria hospital will soon start a new service that they have called the “Nicholas’ room” (named for ‘our’ Nicholas) to denote an environment of serenity to give psychological support not just to the families of organ donors but also to those who decided not to donate. “These people do not deserve to be judged, but must be supported and helped,” the group’s president, Nadia Biancato, said.

“That ‘no’ said in a dramatic moment can lead to beautiful unselfish deeds in the future.” It can also stimulate them to talk of their experience so that others might make different decisions about organ donation, she added.

Aido Alessandria - Nicholas' room

The introduction of “Nicholas’ room” project

The plan is to extend the project to all other areas of Piedmont. The City of Health hospital in Turin, Piedmont’s capital, already runs a similar project for donor families and has been very pleased with the results but the Alessandria version is the first in Italy to include non-donors.
Here are two links to local news sources (in Italian):

https://radiogold.it/cronaca/315900-alessandria-sostegno-psicologico-famiglie-donazione-organi/

https://www.ilpiccolo.net/generic/2022/06/08/video/nicholas-green-e-la-casa-che-da-supporto-psicologico-140764/

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The letter from the father of Nicholas Green: “My battle to allow contacts between the two sides in organ donation”

(Article by Reg Green published in ‘La Repubblica’, an Italian national newspaper. March 3, 2022)

When Dan and Shirley Mason. an American couple, met Inger Jessen, who when 55 years old had received the heart of their 18-year old daughter, Nicole, it was one of the most meaningful events of their lives. They all hugged, cried with joy and exchanged stories. They have become close friends.

The dramatic culmination of their first meeting was when the Masons heard through a stethoscope the steady beat of their daughter’s heart. “I couldn’t believe it,” Dan said later.  “Since Nikki was killed in a car accident twenty years ago, I think of her every day. She seems so far away. But here she was again.” Inger too was profoundly moved. “Since then,” she says, “I have felt a peace I haven’t known in years.”

     As the father of Nicholas Green, the seven-year old California boy who was shot in an attempted robbery on the Salerno to Reggio Calabria autostrada and whose organs and corneas my wife, Maggie, and I donated to seven very sick Italians, I share their view: the bonds we have forged with those seven have had a healing effect on all of us.

     On our side, we have been gratified to see how our son’s organs have transformed life for people who were once on the brink of death. To give just one example: Maria Pia Pedalà, the 19-year old Sicilian who received Nicholas’ liver had a baby four years after the transplant — an impossible happening beforehand. She called the baby Nicholas and in a family with a history of liver disease he is fit enough to have become a non-commissioned officer in the navy.

    On their side, the recipients can see we don’t hold it against them that they are living only because our son died — and that has freed them from the sense of guilt that many recipients carry with them for the rest their lives. Twenty-seven years after the transplants, five of the seven are still alive.

   But communication between organ donor families and their recipients is almost impossible in Italy under a law (91/99) that was passed more than twenty years ago because lawmakers feared that any contact, even if both sides want it, risks psychological damage. Even anonymous letters are forbidden!

     In the United States, however, tens of thousands of families have either met face to face or have written to each other and in the overwhelming majority of cases the happiness and health of both sides have improved. In fact every one of the 58 organ procurement organizations in the United States, that under the Department of Health look after both donors and recipients, encourages contact.

La Repubblica Facebook post - March 12 2022

The article had more than 16,000 likes on the Facebook page of the newspaper

     Of course, these contacts are planned in conjunction with the families’ medical advisers: finding each other through the Internet, as some Italian families do, is asking for trouble. Contact usually begins when one side writes anonymously to their transplant team, who scrutinize it to make sure there is no sign of risk, such as an overwrought family or one likely to make emotional demands on the other side. If the family receiving the letter does not want to write back, communication stops cold. If they want to reply, however, they do so, also anonymously, and the first family also has the option of continuing or breaking off the conversation there and then. After a while, however, both sides can reveal their identity if they wish and share their experiences as many thousands have.

     The result of all this care is that none of the morbid forecasts of things going wrong has happened on any scale. For example, I couldn’t uncover one case in America of a donor asking a recipient for money. Instead, imagine the thrill we had when a cousin of the 15-year old who received Nicholas’ heart told us that after the transplant he said to everyone he met, “I used to have a worn-out old jalopy for a heart. Now I have a Ferrari.”

     To this day in Italy when those who oppose liberalization are asked for proof of any significant numbers of things going wrong they are unable to provide them. Can things go wrong? Of course. But the thousands and thousands of medically documented cases where things went well in the US are evidence that the problems are extremely rare. I challenge opponents of change to show any statistics of problems.

     Despite all this, when I, with just one helper, Andrea Scarabelli in Rome, started a campaign in 2016 to liberalize contacts between the two sides in Italy we were so alone that we became known as Don Quixote and Sancho Panza. But we sent the evidence we collected to every national organization involved in transplantation and, after studying it, all of them — the National Transplantation Center, the National Bioethics Committee and the National Institute of Health — have come out in favor of contact when it is done under authorized medical supervision and when both sides have clearly expressed a desire for it. Dr Pierpaolo Sileri, Deputy Minister of Health, has said firmly, “La liberalizzazione dei contatti tra riceventi e donatori è un gesto di umanità e civiltà, un atto doveroso”. I hope readers of this article will support the legislation that has been introduced to allow that to happen and relieve a lot of unhappiness in families who have performed one of the most selfless acts our society knows.

(Link to the article in Italian: https://www.repubblica.it/cronaca/2022/03/03/news/la_lettera_del_papa_di_nicholas_green_la_mia_battaglia_per_far_incontrare_chi_ha_donato_gli_organi-340120452/)

Author: Reg Green.

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Italian Organ Donation Rates Rebound to Record Levels

Organ donation rates in Italy are of great interest to Maggie and me because when our seven-year old son, Nicholas, became a donor there 27 years ago, the rates were almost the lowest in Western Europe. They are now among the highest. The latest official figures, just out, show donation rates have more than made up the decline that came with COVID-19 in 2020. Last year they went up 12.1 percent, reaching a rate of 22.9 per million of the population. When Nicholas was killed it was a little over 6 per million.

organ donation report 2021 by region in Italy

Source: Italian National Transplant Center (CNT) and SITO (Italian Society for Organ Donation) annual report

Many people express surprise that donations are such a low percentage around the world (“only 22 per million?” they say) but that is because donating organs is possible for only about 1 percent of the population, mostly people who die of a blow to the head as in a road accident, a fall or violence. The new figures show that 69 percent of Italians say they would become donors if they are eligible. This is a phenomenal change and people and institutions of all kinds have played their part.

Transplants over the years - preliminary data on 2021

Source: Italian National Transplant Center and SITO report – preliminary data

Speaking only of our own campaign, they range from Pope John Paul II — who showed how deeply moved he was by Nicholas’ death and the generous-hearted response of the Italian people, by authorizing the casting of a magnificent bell with the name of Nicholas and his seven recipients on it — to ordinary people all over Italy,  some in their thirties and forties who were then just children, even people not born at the time but who have heard the story from their parents or teachers.

IMG_2755 SITO CONFERENCE, ROME 2016

Reg Green speaks at SITO conference (Rome, November 2016)

Most of the individual names will be unfamiliar to readers but they show the variety of our allies. First is Andrea Scarabelli, with whom I have worked hand-in-glove from within days of Nicholas’ death, and who I call Nicholas’ best friend. Without him ‘the Nicholas Effect’ could easily have petered out after a few years instead of being a force virtually every adult Italian still knows about.

     So let me take this opportunity to publicly thank the Ministry of Health, the National Bioethics Committee, the National Transplantation Center and the National Institute of Health, in all of which we have close contacts. And, thank you, Italian journalists for recognizing the importance of organ donation even when it was not making the headlines: your ability to see the suffering of real people behind the statistics made me feel very proud of being a journalist too. But especially I want to thank Luca Dini, former editor of Vanity Fair Italy and now editor of “F” magazine, Maria Emilia Bonaccorso, the health editor and Livia Parisi, the health reporter at ANSA, who have been the three media people most loyal to Nicholas’ memory.

IMG_2772 SITO CONFERENCE, ROME 2016

At SITO conference (Rome, November 2016)

Thanks also to those branches I have visited of Aido (the volunteer group that works with donor families and recipients) with whom I have had some of the most enthusiastic meetings of my life — and especially the heroic and tenacious Piero Gallo at Aido Giussano — whose commitment has never wavered from the moment I met him — and to three of the most beautiful women in the world (Jamie Lee Curtis, Alessia Marcuzzi and Sophia Loren) all of whom have told me personally how deeply moved they were  by Nicholas’ story. Thanks also to Professor Natale De Santo and other professors of medicine, transplant physicians and nurses, to Giusy De Rosa, a teacher who I first met at one of the 31 schools that, all over Italy from the Alps to Sicily, were named for Nicholas, to Marco Galbiati (another father who lost a beloved son and joined us by collecting fifty thousand signatures after we began a national campaign to allow donor families to meet recipients) and the thousands — yes, thousands — of other people who have worked with us in the last 27 years! With such enlightened activists is it any wonder that Italian donation rates are now among the highest in the world?

Reg Green

 

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