Shilpa Darivemula

Shilpa attended Union College in Schenectady, NY, and lived with the Mapuche-Pewenche community in Lonquimay, Chile. Brought up in the tradition of Kuchipudi, an Indian classical dance form, Shilpa noticed how the traditional Nguillatun Mapuche dance intrinsically improved community well-being. In 2013, Shilpa received the Thomas Watson Fellowship to spend one year studying the connections between traditional dance and women's health in Peru, Morocco, Uganda, Cambodia and Laos. She was consistently inspired by the women she met and the hidden potential they carried to act as change-makers for their communities. 

In 2014, Shilpa founded the Aseemkala Initiative to explore the intersection of traditional dance, women's health and medicine. Her medical-dance pieces have been shared at the 31st International Papilloma Conference, ArtWallahLA Festival and the Southern Vermont Dance Festival. Her long-term goals include pursuing an MPH, continuing research on cervical cancer and peripartum infectious diseases, and starting indigenous women-led clinics for midwifery and CHW training as an OB/GYN.


Project: "Exploring Patient Health Literacy of HPV and HTLV Infection Pathophysiologies in Shipibo-Konibo women"     
January 1, 2018 - February 25, 2018
Peru


 


What does the Kean Fellowship mean to you?
Cervical cancer remains the fourth most common female cancer worldwide. Trends demonstrate a decrease in mortality due to HPV vaccinations with regular screening. Unfortunately, this reduction is not seen globally. Cervical cancer is especially prevalent in Peru, where HPV-induced cervical cancer is the most common female cancer. The foundation of most STD prevention education is based on the woman’s power to choose. Practices such as safe sex measures, limiting sexual encounters and attending annual checkups are not available strategies for women in abject poverty with limited access to resources. This is especially true for the Shipibo-Konibo women of Cantagallo, the Shipibo diaspora community of Lima. Biologically and culturally, Shipibo women are at high risk for cervical cancer from HPV infection. Risk factors include limited Spanish skills, tobacco use, lack of protection during intercourse, cultural norms surrounding female sexuality and multiple sexual partners. 

I worked with Shipibo communities during my year travelling and noted how multifaceted these factors are. Many economic, cultural, and societal realities contribute to this higher incidence of HPV infection in this indigenous community in ways that clinical medicine alone cannot address. In order to truly affect change, we must understand the community and ask them how to approach the root issues of their health behaviors. This type of collaborative decision-making requires time, humility and patience.

The Kean Fellowship is a unique privilege and honor as it provides an opportunity to develop and implement a tropical medicine public health research project in real time. By working in the Obstetrics and Gynecology wards in Universidad de San Marcos in Lima, Peru, and in the Shipibo Cantagallo slum, I hope to collaboratively develop new evidence-based, culturally compatible HPV infection prevention strategies with the Shipibo women.

What do you anticipate learning?
The edifice of medicine rests on the foundation of a thorough history and a complete physical exam. Understanding patient stories and performing a physical exam in resource-poor, culturally-diverse global health settings will be challenging. I hope that, through my interviews of Shipibo women and my work on the Ob/Gyn floors at UNM, I will gain a deeper understanding of the Shipibo people, their needs and whether I have the capability to fulfill them. The natural history of a disease depends on how societies respond to it. The Kean Fellowship affords the chance to understand the cultural context of disease – its own historical course and physical manifestation – to promote development of effective strategies in the future.

What interests you about tropical medicine and what problems are you interested in solving?
Access to healthcare is a basic human right denied to many indigenous communities. Indigenous people are at higher risk for emerging infectious diseases and carry a disproportionate burden of neglected tropical disease infections. This risk is due to inequities in resources, instability from conflict and destruction of cultural knowledge and ancestral lands. Tropical medicine investigates diseases endemic to indigenous populations and is solution-focused. Some of the most innovative strategies have arisen from outbreak control studies. Tropical medicine also demands an understanding of the local culture and customs, requiring a unique respect for the environment and community in which it strives in order to reduce the burden of disease. These strategies have also empowered indigenous women to catalyze progress. The potential for organic multi-pronged improvements offered by tropical medicine is a medium to address human rights for indigenous women and help them eradicate cervical cancer in their own communities.