In 1877, when war broke out between Russia and Turkey, Clara attempted to form an American Red Cross Society. However, the United States government would not accept the Treaty of Geneva. Clara wrote a pamphlet, "The Red Cross of the Geneva Convention: What It Is." She published it in hopes of educating the public. On May 21, 1881, the American Red Cross was formed. Clara's dream had become a reality. The first chapter opened in Dansville on August 22, 1881. With the assistance of Susan B. Anthony, a second chapter was opened in Rochester a few weeks later. Clara was the president of the American Red Cross.
On March 16, 1882, the Treaty of Geneva passed through the United States Senate. It was signed by President Chester Alan Arthur. In 1883, new chapters of the Red Cross opened across the United States.
In May, 1883, at the request of former Civil War General Benjamin F. Butler, Clara took a temporary position as superintendent of the Women's Reformatory Prison of Massachusetts. She served there for only six months.
Clara returned to the Red Cross in February 1884. In September, she attended the Third International Conference of the Red Cross in Geneva. The conference accepted the principles that Clara had instituted in America. The Red Cross would help victims of disaster in time of peace. Clara received the Augusta Medal from Empress Augusta of Germany, for her humanitarian work.
In the 1890's, Clara worked with Potomac Corps, the Grand Army of the Republic and the Daughters of the American Revolution. She established the headquarters of the American Red Cross at the corner of F and 17th Streets in Washington, DC. In 1897, she moved the headquarters to Glen Echo, Maryland. She was awarded the Second Order of Shefafet by the Pasha of Constantinople for her service to the Ottoman Empire, for providing relief to Christian Armenians and Turkish Muslims. The award had never before been presented to a woman.
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