Improvised care: Jewish refugee medicine and public health in wartime Shanghai, 1938–1945

Between 1938 and 1941, nearly 20,000 Jewish refugees fleeing Nazi persecution arrived in wartime Shanghai, a city already destabilized by the Sino-Japanese War (1937-1945), mass displacement, and fragmented governance. Their arrival exposed the limits of Shanghai's overstretched public health system while also generating new forms of medical organisation, refugee self-governance, and intercultural collaboration. Drawing on archival records, refugee memoirs, wartime newspapers, and medical journals, this article reconstructs the development of an improvised yet integrated refugee healthcare infrastructure between 1939 and 1945. The article argues that refugee medicine in Shanghai evolved beyond emergency relief into a broader regime of care comprising hospitals, nutrition programmes, sanitation campaigns, disease surveillance, and work-relief initiatives. Far from being passive recipients of humanitarian aid, refugee physicians became central actors in constructing and administering this system. In conditions of institutional fragmentation and material scarcity, they adapted European medical knowledge to unfamiliar climatic and epidemiological environments, collaborated with Chinese practitioners and local institutions, and contributed to new forms of medical knowledge production. The Shanghai case complicates conventional narratives of humanitarian governance and colonial medicine. Rather than operating under a centralised state or colonial authority, refugee healthcare emerged through negotiations among municipal authorities, international aid organisations, occupying military force, and Jewish communities. Wartime Shanghai thus became not merely a 'port of last resort,' but a significant site of transnational medical production in which displacement reshaped both medical practice and the meaning of care.