[9][10][11] After 13 years as an Army Nursing Sister, she was promoted to the position of Superintendent in May 1899 and served in the Second Boer War in South Africa from January 1900 until 1902.
[13][14] She was promoted to Principal Matron, QAIMNS, South Africa, 1911–1914; Principal Matron, Nursing Inspector QAIMNS, 1911–1914, and attached to the British Expeditionary Force, France, 1914–1915, before her final appointment as Acting Matron-in-Chief in 1915 of the Mediterranean Expeditionary Force.
[15][16][17] Oram was appointed a Dame Commander of the Order of the British Empire in 1919 and invested on 10 March 1920 at Buckingham Palace.
Dame Sarah Oram died, unmarried, on 26 June 1946 in South Kensington, London, aged 85.
[18] The funeral took place at St George's Church, Campden Hill, and Oram was cremated at Kensal Green Crematorium on 1 July 1946.