[citation needed] For four very difficult years, Dr. Dengel struggled to make an impact on the health care of the women and children in northern India.

She became convinced that many more professionally trained and spiritually dedicated women were needed in order to effect real healing among the people.

She encountered the same barrier which her mentor, McLaren, had in her own pioneering service in healthcare to the women and children of Muslim India, namely, the prohibition in Church law barring members of religious institutes from practicing medicine.

"[citation needed] Permission was granted on 12 June 1925 to begin the new congregation, and on 30 September that year the "First Four"—Anna Dengel along with Johanna Lyons, M.D., of Chicago, Evelyn Flieger, R.N., originally from Great Britain, and Marie Ulbrich, R.N., of Luxemburg, Iowa—came together in Washington, D.C., to found the Society of Catholic Medical Missionaries.

Her body was buried in the Teutonic Cemetery (reserved to natives of Germanic nations serving the Catholic institutions of Rome[3]), which is within the territory of Vatican City.