After jumping into the river in his T-shirt and shorts, Cpl. Jacob Cogswell battled a strong current to bring the teenager to safety.
The hospital where the Marines were sent had been planning a mass-casualty response training for the day of the real-life emergency.
Lt. Gen. Roger Turner, whose promotion had been among hundreds blocked by one senator, took over III Marine Expeditionary Force on Friday.
The site for the base on the eastern coast of Okinawa has been at the center of a dispute between the government in Tokyo and the local authorities.
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