In 1918, at the age of 46, Sara was certified by the American Red Cross. She joined Near East Relief, an organization created to help civilians affected by World War I, in 1919. Soon after, she landed in Constantinople (Istanbul) with 250 other relief workers. She helped rescue and care for thousands of Armenian and Greek orphans over the next decade, often risking her life in the process.

World War I had ended in 1918, but postwar conflicts continued to rage. The Greco-Turkish War of 1919–1922 was one such conflict. By September 1922, Turkish forces were pushing an invading Greek army back to the Aegean coastal city of Smyrna (Izmir). Amid the turmoil, hundreds of thousands of people flooded into Smyrna with hopes of being rescued by Allied warships. The American navy chose to pursue a policy of strict non-involvement, however, and the Red Cross and Near East Relief were instructed to evacuate only those who were American citizens. A medical team, which included Sara, was assigned to assist. Initially forbidden from bringing locals aboard the ships, they were able to set up triage stations for the refugees. On September 13, a conflagration began to rage. As Turkish forces entered the city, entire neighbourhoods were set ablaze. Under these conditions, Sara and her colleagues rescued hundreds of children trapped inside two schools. They led them through the smoke and bloodshed, finally delivering them to American warships headed for Greece.

Returning to Chegoggin, she lived in her childhood home until her death in 1969, at the age of 97. Her headstone was inscribed with the words “She Lived to Serve Others.”