ITOMAN, Japan - Seventy years after the Battle of Okinawa, Yoshiko Shimabukuro still has terrifying nightmares of watching friends and Japanese soldiers die as they hid in caves to escape fierce American shelling.
One of 222 female students mobilised as a battlefield nursing unit for the Imperial Army in March 1945, she also suffers deep pangs of guilt for surviving the war while many of her classmates perished in the hell holes that served as military hospitals on the island's southern tip.
"We only had basic training in how to put on bandages, but the wounded soldiers they brought in were beyond help," Shimabukuro told AFP ahead of a ceremony Tuesday to mark the 70th anniversary of the end of the battle.
"They had legs ripped off, their intestines were falling out, faces missing. We simply had no idea what to do. I was 17. We all thought we would be back at school in a week."
Fewer than half of the girls known as the "himeyuri students" - an amalgam of the names of the two schools they came from - survived the 82-day battle, which wiped out a quarter of the subtropical island's population.
Many died after being ordered by Japanese soldiers to leave their caves in a hail of bullets as the enemy closed in. Others plunged off cliffs or blew themselves up with grenades rather than surrender.
"We wanted to stay in the caves and die together but the Japanese soldiers sent us away," said Shimabukuro, fighting back tears. "People were quickly killed or badly injured. But we couldn't take the injured with us, we had to leave them.
"I still have dreams where I see my dead friends and I wake up screaming. It breaks my heart that I lived and my friends died, without me knowing how, when or where."
The battle claimed the lives of more than 100,000 Okinawan civilians and 80,000 Japanese troops, whose grim resistance only ended after Lieutenant General Mitsuru Ushijima, the senior officer on the island, committed ritual suicide on a cliff.
Almost every family in Okinawa suffered at least one casualty as the US bombardment - by land, sea and air - reduced the normally lush, green landscape to a scorched wasteland.
More than 12,000 American troops also perished during the worst bloodshed of the Pacific War, in what many feared at the time was a foretaste of the battle they would have to fight for the Japanese mainland.
That battle never came, thanks in part to the atomic bombing of Hiroshima and Nagasaki. Okinawa was the only part of Japan in which fighting took place in World War II.
Shimabukuro lost her two elder siblings and was almost robbed of her sanity in the filthy underground hospitals, where soldiers had limbs amputated with little or no anaesthetic and begged doctors to kill them.
Some troops became deranged and grew violent as toxins infected wounds that were crawling with maggots, according to Shimabukuro.
"They were taken to the back of the cave and put in isolation," she whispered. "We weren't allowed to go back there. The constant screaming was dreadful."
After the June 18 order to disband the himeyuri unit, Shimabukuro herself almost died from serious infection before being rescued by a US soldier.
"We were told any women captured would be raped and burned alive," she said. "I would have killed myself if I'd had a grenade, but he gently nursed my wounds and took me to hospital."
Zenichi Yoshimine, who was waiting to begin elementary school when war broke out, said Okinawans - long discriminated against by mainlanders - had been hoodwinked by Japanese propaganda.
"We were taught Japan was God's country and couldn't lose the war," he said, overlooking the spot in Itoman dubbed "suicide cliff" by American troops.
"We believed the Americans were devils, that they were savages and if they captured us they would cut our ears and noses off, gouge out our eyeballs and run over us in their tanks."
'Mice in a trap'
Yoshimine told how tens of thousands fleeing the advancing US troops poured onto clifftops, sending hundreds toppling onto the rocks below as they were strafed by enemy fire.
"There was literally nowhere left to run," he said. "We were caught like mice in a trap. Very soon there were so many bodies we were tripping over them."
Resentment over the war still runs deep in Okinawa, a formerly independent kingdom annexed by Japan in the 19th century.
With thousands of American troops still stationed on the island - a legacy of a long US occupation - tensions run high, and the planned relocation of a controversial US air base, which some locals want moved off Okinawa instead, has triggered angry protests in recent months.
That has coincided with a push by the nationalist government to give the military greater scope for action - something opponents say runs counter to the hallowed pacifism enshrined in Japan's constitution.
Shimabukuro fears that Okinawa, which returned to Japanese rule in 1972, could become a battle ground once again.
"I'll never forgive Japan for what happened," said the 87-year-old, now the director of a museum dedicated to the nursing corps.
"And now we have peace, Japan is trying to change the constitution and turn itself into a country that can wage war again," she added. "And that would drag this poor island back into the firing line."