In 1975, when the Rotary Clubs of Manhasset and Kampala joined forces to bring a 5-year-old Ugandan, Grace Agwaru, to Roslyn’s St. Francis Hospital for a life-saving operation, Gift of Life International was born.

Forty-seven years later that once-little girl returned to where her second chance began last week.

“Being here today, first of all, I’m very excited to be back at the hospital,” Agwaru said on the hospital’s front lawn, “because this is really where my life was saved.”

Agwaru’s parents had told her she wouldn’t live beyond 16 because of a hole in her heart. That changed after Robbie Donno, the founder and president of Gift of Life, found her story in a Rotarian magazine.

He and other Rotarians assisted Agwaru and her father, Silvester, and transported them to America, where doctors saved her life. But unbeknown to those involved, this single instance would spark countless more.

Thanks to its vast global network, Gift of Life has operated on nearly 44,000 children from 80 different countries. It also provides equipment and training so that local doctors can do procedures on their own.

“We have received the greatest gift,” Agwaru said. “And you have given the greatest gift that you can ever give to anyone.”

In the United States alone, 40,000 infants are born with heart defects yearly. If found, doctors will treat an American newborn within the first six months of life. But a procedure may never occur for those living in places without the infrastructure.

Agwaru, now 52, has not forgotten her gift. After receiving her master’s degree, she brought the Rotary Club and the Gift of Life to Uganda.

Donno said that he could not foresee back then how a single case would become the Gift of Life. Only 29 at the time, he recalled the first meeting Agwaru and her father.

“So [her father] took the chance on coming here and at that time, there was no program,” he said. “To make matters more difficult, when he came here, I met him at the airport — only it was the 29-year-old version of me. He anticipated meeting a gray-haired Rotarian, you know, a more mature person. I looked like I belonged to Crosby, Stills, Nash & Young.”

But despite Donno and Agwaru’s father’s fears, they saved her life. From that single case, it turned into two and continued to grow exponentially. To succeed, he said, his team has always put compassion first and treated each child as if they were their own.

“Wouldn’t you like to go to a little kid and say, ‘What do you want to be when you grow up and have them say I want to be kind?” he said. “Kindness matters. It covers a lot of bases. Every act of kindness comes with the same elements. Whether you’re doing heart surgery or a Boy Scout helping an old lady across the street.”

Because of Agwaru, Donno said that Gift of Life has collaborated with the Ugandan government on a cardiac program at the Uganda Heart Institute. Its doctors will also operate on about 150 children this year in collaboration with Ugandan Rotarians.

“We did research with Dr. Craig Sable out of Washington National Children’s Hospital in Washington, D.C., who did breakthrough studies and research on rheumatic heart disease,” he said. “We think we can impact the lives of 40 million people where we found a way of preventing rheumatic heart disease, which comes from strep. It’s a complicated thing, but we did all of that in Uganda. And all of this started with Grace.”

And now, 47 years later, the two remain intertwined along with every child who has come through Gift of Life. As a 5-year-old from half a world away, Donno said she gave back as well.

“So 200 years from now, children will be born because of what we did,” he said. Children will have life because of what we did today. If you can trace it so that their heritage isn’t necessarily Ugandan, American, Kosovan or Russian, but from an act of kindness, that’s our heritage. That’s our legacy.”