Sarah Casella incorporates One Life...Many Gifts materials in Grade 11 and 12 science classes at Centennial Secondary School in Welland.

By all accounts, Sarah Marshall is a normal 14-year-old. She enjoys ballet, horseback riding, playing the piano, camping and hanging out with friends. Sarah is also in the Guinness Book of World Records for a remarkable distinction she would rather not hold - she's the youngest person in the world to have four organs transplanted at once.

Sarah was born on Valentine's Day 1997 with a rare and usually fatal disease of the digestive system. At not quite six months she received four new body parts at the Children's Hospital in London, Ontario - stomach, pancreas, liver and bowel.

"I am very lucky," Sarah wrote in a speech that she delivered to her class years later. "Without organ donors, people like me would not have a second chance at life."

Sarah's dramatic story is one of many conveyed in One Life...Many Gifts (OLMG), a secondary school curriculum program aimed at students in Grades 11 and 12 on the importance of organ and tissue donation and transplantation.

The program was developed by the Trillium Gift of Life Network (Ontario's organ and tissue donation agency), the London Health Sciences Centre and the Kidney Foundation of Canada. Funding came from the Ontario Ministry of Health and Long-Term Care, the Ministry of Education, an anonymous donor and Trillium Gift of Life.

OLMG started rolling out in the 2008-09 academic year. By the end of 2010-11, in-service training will have been completed with 900 teachers in 685 secondary schools across Ontario.

One of those teachers is Kris Ross, OCT, who teaches math, history, English and Special Education at Cornwall Collegiate and Vocational School in the Upper Canada DSB. Ross says that transplantation isn't on the radar of many students - and even when it is, there are often misconceptions. "They assume that organs are readily available and that matches can easily be made, or they don't know the circumstances under which organs can be donated," she says. "Hopefully, the discussions will enable students to pose critical questions and make informed decisions about organ donation."

Only 17 per cent consent

In Ontario, more than 1,600 people are on waiting lists for life-saving organ transplants - kidneys, livers, hearts, lungs and more. Thousands more need tissue transplants to live their lives to the fullest. But only about 17 per cent of Ontarians have registered their consent to donate.

Kris Ross, who teaches at Cornwall Collegiate and Vocational School, says OLMG is both personally and professionally important to her.

"Every year about 100 people die waiting for a transplant," says Frank Markel, President and CEO of Trillium Gift of Life. He hopes that One Life...Many Gifts will tap into what he calls the "tremendous idealism" of young people and their desire to make a difference.

The learning program includes a series of booklets with narratives of organ and tissue recipients, donors and donor families, and an award-winning DVD. The booklets cover topics including the history of donations and ethical considerations, as well as taking a detailed look at specific types of donations. All materials are available in French and English and can be downloaded at the OLMG web site.

The material is designed to be versatile - to be used in science, health and physical education, English, the arts, Canadian and world studies, guidance and careers, social studies and humanities, civics or religious-education classes. There are sample instructional units for each subject. Suggested student activities range from discussion and role-playing to the creation of a public service announcement or a scientific presentation on the role of the kidney.

"It's a very flexible curriculum," says education consultant Joan Green, a program adviser for OLMG. "We tried to provide all of the tools teachers need, so the program is ready to go."

"You have ready-made handouts and activities, much more than what you would expect in a typical resource," says Marco Donato, OCT, who teaches family studies at St. Elizabeth Catholic High School in Thornhill, part of the York Catholic DSB. "The material is clear, informative and teacher friendly."

Clint MacNeil, OCT, who has taught OLMG in his Grade 12 religion classes at St. Charles College in the Sudbury Catholic DSB, concurs: "Quite literally, you can pull the binder off the shelf and everything is there for you. The resources are interesting, eye-catching and easy for the students to relate to. It prompts some important dialogue."

Real-life stories

Green, a former teacher, principal, superintendent and Toronto DSB Director of Education (and a former CEO of the Ontario Education Quality and Accountability Office), says that the compelling true stories, like that of Sarah Marshall, are what draw in students and serve as a jumping-off point for discussions and exercises.

In one of the stories, students encounter a boy named Lucas Belisario, who received a kidney from a living donor - a stranger who had never met Lucas but whose wife was a secretary at his school. "I thought, I can live fine with one kidney if it means saving a life," said the donor. They learn about Janet Brady, who at 34, with two young children, was dying of a rare liver disease. After nine months on a waiting list, with time running out, she received a new liver. She was discharged from hospital on Thanksgiving. "How fitting," she says. "Every day I give thanks for receiving a second chance to live with my family and friends."

And they discover a man named Joe Fleming, who lost his sight in one eye at age nine. In his mid-20s, Fleming received a cornea and lens transplant that restored his vision - a life-changing event for someone who is an artist and an art professor.

"What touches the students most are the stories," says Paul Miki, OCT, who teaches religion at Cardinal Carter Catholic High School in Aurora in the York Catholic DSB. "The statistics are important, but when the students hear the stories and see the video, there's an emotional connection that reinforces the need to care about this issue."

For Miki, One Life...Many Gifts is an integral component of ethical education. "We ask ourselves what are our responsibilities to others, to those in need, so this program resonates," he says.

Underscoring the flexibility of the program, Sarah Casella, OCT, says that OLMG is just as applicable to her Grade 11 and 12 science classes. "It fits into my body-systems unit, which introduces the importance of different organs."

Casella, who teaches at Centennial Secondary School in Welland, usually does a three-day unit on OLMG and at the end of the first lesson encourages her students to talk about organ and tissue donation with their parents. The program is a perfect opportunity, she says, to generate family discussions about a subject that otherwise may rarely come up.

Sudbury leads the way

One place where organ and tissue donation and OLMG are very much on the community agenda is Sudbury. The Sudbury Catholic DSB is spearheading a challenge to make its city the first in Ontario to reach a 50 per cent donation-consent rate. By early 2011 the rate was already at 40 per cent, well above the provincial average of 17 per cent.

"We see it as a social-justice issue," says Catherine McCullough, OCT, Director of Education at the board. "Donating organs and tissue is our moral responsibility as citizens. I'm stunned that the consent rate in Ontario is so low."

David, a Grade 10 student and member of the student council at St. Charles College, agrees. "I know it's the right thing to do," he says, "leaving something of yourself behind to help someone else live their life."

He adds that the OLMG program has prompted many lively conversations among his classmates as they put themselves in various scenarios. For instance, how would you feel if you needed a transplant and there was a match, but that individual refused consent? "It really makes you think." David agrees that OLMG, while not mandatory, is an essential topic to teach in school. Most students, he says, just wouldn't make the effort to learn about it on their own. (New Jersey is the only jurisdiction in North America, Markel reports, to make organ-donation education compulsory in the high school curriculum.)

The 1,600 people on Ontario's transplant waiting list are not just statistics, says Susan Smyth of Sudbury. They're someone's mother or father, sister or brother, grandparent or child. When the Sudbury Catholic DSB kicked off its community challenge in December 2010, Smyth spoke about the importance of registering as a donor. Just a month before, her son Ian had passed away at 16 from complications after a double lung transplant.

Marco Donato teaches family studies at St. Elizabeth Catholic High School in Thornhill and was an author of one of the OLMG resources.

Ian had two transplants, one in May 2008 and another in January 2010 when the first one failed. Though Ian's story didn't have a happy ending, Smyth says the transplants gave her and her husband Phillip and Ian's brother Connor that much more time with him. For that, she is grateful. Smyth is confident that informing more students and the broader community about organ and tissue donors will make a difference. "If you can, why wouldn't you give someone else the chance to live?"

Strong support

A 2009 evaluation report on OLMG found widespread support of the program from teachers and students alike. The vast majority of students had positive views of the curriculum, and 25 per cent even thought it should be mandatory.

After participating in OLMG, a significantly higher percentage of students signalled their intent to become donors and discussed their wishes with their families. The survey also shows that OLMG is effective in dispelling certain myths, such as the belief that a particular culture/religion doesn't support organ or tissue donation.

The teachers surveyed said that the curriculum was so engaging that even students who were often reluctant to get involved in discussions participated.

Donato, one of the writers of the OLMG supplement for Catholic schools, isn't surprised that students show maturity in talking about it. "The subject appeals to the intrinsic goodness within us," he says.

He adds that students begin to realize how many people have been touched by organ and tissue donations, often in their own circle. Donato's own brother, Abraham, was killed in a traffic accident in 1992, just shy of his 21st birthday. His family consented to Abraham becoming a donor. "It was a great source of comfort at the time - and still is," says Donato.

Another teacher for whom OLMG hits home is Kris Ross. She was diagnosed in 2002 with a ventricular septal defect. "Basically a big hole in my heart," she says. It resulted in permanent lung damage. Ross is on medication to slow the progression, but at some point she'll likely need to go on the waiting list for a heart-lung transplant.

"One Life...Many Gifts is both personally and professionally important to me, because it gives me hope," says Ross.

The day she took the in-service training for OLMG in March 2011 happened to be her 38th birthday, which Ross thought was entirely appropriate. "It was a great way to spend my birthday," she says, "because it's nice to know that people are actively trying to make a difference - and trying to make sure that people like me get more birthdays."

Visit the web site - students at Centennial SS in Welland spell it out.