Rupa is a physician, an activist, a mother, and a composer. She is an associate professor of medicine at the University of California, San Francisco, where she practices and teaches internal medicine. She is a co-founder of the Do No Harm Coalition and co-founder and co-director of the California Tribal Fund. At the invitation of Lakȟota health leaders, she is helping to set up the Mni Wiconi Health Clinic and Farm at Standing Rock to decolonize medicine and food. Working with her husband, agro-ecological farmer Benjamin Fahrer and the Association of Ramaytush Ohlone, she is a part of the Farming is Medicine project. Her book on the health impacts of colonialism–Inflamed: Deep Medicine and the Anatomy of Injustice--written with Raj Patel will be out internationally August 2021.