The Life and Times of Okinawa's 'Florence Nightingale'

Seventy-nine years have passed since the end of the Pacific War and the Battle of Okinawa that preceded it. Despite the passage of nearly eight decades, and much research and writing about the battle, there is one key figure who has not received the attention she deserves. This person was a military nurse who cared for Okinawa's "Himeyuri Students." She not only survived the Battle of Okinawa — which killed more than 200,000 people including local residents caught in the fighting — but lived to play a crucial role in the development of nursing in postwar Okinawa. 

While there are many books, articles, and documents that tell the story of the Battle of Okinawa, the story of the nurses who helped those injured in the fighting is less well-known. However, the history of war and nursing has always been deeply intertwined, and the Battle of Okinawa is no different.

A Heroine of the Battle of Okinawa

Nobu Madanbashi was born in 1918 in Shuri, Okinawa Prefecture. As a student, in the 1930s, when the clouds of war were gathering, she chose nursing as "the only way for women to contribute to the fatherland." She spent the rest of her life in nursing. 

Nobu, as she was known, was subsequently mobilized in 1939 to work at the Nagoya Army Hospital. There, she spent her days and nights caring for sick and wounded soldiers who were constantly arriving from the China front during the Sino-Japanese War.

After spending the next four years and eight months experiencing the realities of war, Nobu returned home to Okinawa when her mobilization orders ended. She became a health nurse at her alma mater and taught emergency nursing to the students. These girls would become the student nurses known as the Himeyuri Student Corps, also known as the Lily Corps, many of whom tragically died in the Battle of Okinawa.

A Living Hell

At the end of March 1945, when the battle began, Nobu volunteered to become the head nurse at the Okinawa Army Hospital. While directly supervising the "Himeyuri Students," who were mobilized as nursing personnel, she worked tirelessly, without sleep or rest, to provide first aid and nursing care for the wounded soldiers.

On April 1, the United States military began to land on the main island of Okinawa. The number of sick and wounded increased by about 3,000 a day in the fierce ground fighting. Hospital shelters were overflowing with wounded and sick. Many had to be treated outside. Without adequate light or sterilization equipment, the shelter was filled with maggots, lice, and other insects. The stench was overwhelming. It became a living hell.

After the defenders retreated to the southern part of the island, two young nurses in the Second Surgical Shelter in the Itosu district undertook a "suicide mission" in the final stages of the Battle of Okinawa. A doctor, having given up on the war, directed one of the soldiers to tell the medical staff in a nearby shelter to disperse. However, the soldier rushed back in after coming under fire from American troops outside the cave. 

Courage Under Fire

Looking at the soldier, Nobu told the doctor that she and another nurse would go deliver the message. They crawled through night flares and machine gun fire to deliver the order to disband.

On June 19, the two bivouacs were attacked by the US military with white phosphorus shells. In Nobu's shelter, despite the smoke, she and her staff remained calm after dipping gauze into the stream running through the cave to cover their noses and mouths. 

Two days later, Nobu, decided to surrender along with her staff and led them out of the cave. They became prisoners of war while on the way to Mabuni. Her duty as a head nurse was finally over. Thanks to Nobu's decision, many of the wounded soldiers and nurses in the surgical shelter survived. 

However, in the other shelter the US military attacked, Nobu was not there to keep the occupants calm or conduct an orderly surrender. Confusion reigned, and instead of surrender, the occupants elected to commit mass suicide, resulting in a tragic loss of life many of the "Himeyuri Students" whom Nobu had taught were there. The cenotaph, "Himeyuri Monument," stands on the site of this surgical shelter.

Postwar Contributions to Nursing

After the war, Nobu rebuilt nursing education and the care of war orphans in the POW camps from scratch and was considered a leader in rebuilding nursing in Okinawa. In the midst of these efforts, she met Juanita Watterworth, a nursing instructor in the US Army, who would make great strides to help postwar Okinawa.

Watterworth lit the fire in Nobu to continue to teach nursing again in honor of her fallen students and colleagues. Nobu later said, "It is a joy to be alive and able to practice nursing again."

Watterworth told all who would listen that "nursing has no borders" and that she would help to "raise Okinawa's nursing to international levels." 

Watterworth would spend ten years in Okinawa, remaining there until 1960. During this time, she and Nobu worked together to modernize nursing in Okinawa by establishing a modern nursing administration and education system, creating a nursing association, and training nurses.

A Lasting Legacy

In 1951, the Okinawa Islands Nurses Association was founded and Nobu became its first president. This association later evolved into the Okinawa Prefecture Nursing Association and contributed greatly to improving the standing and qualifications of the nursing profession.

Beginning in 1952, Nobu worked for 14 years in the Ryukyu Islands Government Health Department as the head of the Nursing Section in the Medical Affairs Division. There she restored and registered nursing licenses that had been lost during the war, sent nurses to mainland Japan and abroad for training, and established the infrastructure for nursing administration. 

Even after Watterworth returned to the United States, Nobu's commitment to improving nursing care in Okinawa remained strong. With the rebuilding of the island and the construction of new medical facilities, she assumed the position of general nurse at the Central Ryukyu Hospital, the University of the Ryukyus Hospital, and the Naha City Hospital respectively, paving the way for her successors.

Receiving the Highest Honor

It is said that due to the efforts of Watterworth and Nobu, the standard of nursing care in Okinawa was higher than that in Japan before Okinawa's reversion to Japan in 1972, thanks to American-style nursing education, extensive training programs, and technical training.

In May 1985, the International Committee of the Red Cross (ICRC) awarded its highest honor, the Florence Nightingale Medal, to Nobu. She was the first person from Okinawa Prefecture to receive it. 

In her speech after receiving the award, Nobu quietly expressed her joy, saying that she wanted to "dedicate it to the Himeyuri students and her fellow doctors and nurses who died during the war."

Nobu died in 2004 at the age of 85. In 2017, her relatives established an institute in Okinawa Prefecture to pass on the memory of the Battle of Okinawa from the perspective of nursing and the documents and materials she left behind. The institute has also produced a picture book, Sukubun: The Legend of Nobu Madanbashi, the Nightingale of the Southern Islands, which can be enjoyed by all generations. The book is being disseminated and passed on as a story that describes the connections between the origins of nursing and the Battle of Okinawa. 

Nobu's Story in a Picture Book

Suku-bun is the Okinawan dialect version of the Japanese "shokubun," a word used to describe a role or mission. Through the story of those, especially Nobu, who dedicated themselves to nursing in Okinawa, the book conveys the message of reaffirming one's own mission in life or role in society.

The book is an inspiring one and seems to be enjoyed by all who read it. Also available in Japanese for purchase, it discusses the courageous life and times of Okinawa-born Nobu and especially her devotion to the development of the field of nursing. The book helps readers, especially younger ones, to understand the Battle of Okinawa and nursing. Devotion to duty and to others is a particularly important theme in the book.

The book is a great contrast to the typical, ideologically charged approach when teaching about the Battle of Okinawa and the view of the people of Okinawa as simply victims with no agency themselves. Nobu took her work and commitment to military nursing seriously. 

With the 79th anniversary of the end of the Pacific War approaching, I hope Nobu's powerful story will shed new light on Okinawa. 

On a final note, I should mention her story has personal meaning for me. My father was a member of a US Army medical unit during the Battle of Okinawa. I am sure if he had known that there was a dedicated nurse like Nobu on the other side he would have respected her. They probably never met, so I am happy to introduce them in this article.

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Author: Robert D Eldridge

Eldridge is the author of "The Origins of the Bilateral Okinawa Problem" (Routledge, 2001) and the former political advisor to the Marine Corps in Japan.