With a PhD in molecular genetics, author Aarathi Prasad works in interdisciplinary research at University College, London. Her first book, Like a Virgin: How Science Is Redesigning the Rules of Sex, was published in 2012, exploring how inventions such as the silicone womb could change the future of reproduction. Her latest book, In the Bonesetter’s Waiting Room: Travels Through Indian Medicine, examines the diverse treatments on offer in the country’s cities and rural communities, and the future of Indian healthcare.

In India there are two broad approaches to medicine: conventional “western” medicine and traditional practices, which go under the banner of Ayush. What are these practices?
There are several systems of medicine that the state sanctions for use. One of them is ayurveda, which is a very old system [with medicines often based on herbs, minerals and metals] indigenous to India, and then there is also yoga. Siddha is similar to ayurveda but the texts are different and come from a different part of India. There is unani, which is originally from the Greek hippocratic system of medicine that came to India with Arab scholars. Then there are naturopathy and homeopathy, which are European in origin. Any of these things, you can go to a government-funded facility to use.

Your grandfather practised ayurveda, and was involved in pushing for integration with western medicine after independence. Was that the motivation for your book?
My mother would tell me about him and his work, and at home if I cut my finger we’d go to the kitchen and put turmeric on it. So culturally it was very strong in my upbringing. But I didn’t know that he had pushed for integrated medicine. That was all new to me. When India was a British colony, the study of traditional forms of medicine as medicine was banned. So what do you do when the colonists leave? Do you choose to use the medicine that the colonisers brought or do you go back to what was considered medicine before?

There’s an argument that if a herbal remedy, such as those of ayurveda, has an effect on the body, the chemicals responsible should be identified and extracted so it can be regulated and dosed correctly. How does that fit with the views you encountered?
That’s exactly what many of the people I talked to, and the government, are trying to do – that is, use the best of both. There is the example of a South American plant: tribal people say “the fruit is very nutritious but we also use it for infertility.” And so the ayurvedic gatherers take it back to the lab and look for active ingredients in it. It’s very much like the drug discovery process, but a little less random because scientists are trying to understand the cultural context in which people are already using the plant, and whether they feel it is working. It is anecdote, but anecdote is a form of evidence.

Is there any resistance?
Yes. A lot of westen doctors say, “Keep your knowledge”, while some ayurvedic doctors say, “You are not doing ayurveda properly”. Ayurveda has become like any other medical system where you go to university for a few years, you study a range of subjects, a lot of them western medical subjects. There is friction but I think the future is using the best of both worlds.

In this push for integration is there not a danger of fuelling pseudo-scientific research? One idea is to use modern genetic techniques to investigate “imbalances” in the body’s “humours”, for example…
Ayurvedic research institutes even have a word for it: ayurgenomics. It’s similar to the hippocratic idea of the four humours. In ayurveda there are three, but the idea is the same, that disease comes from imbalance. People have a predominance of one type of “humour” over another and they are looking at whether those categorisations can be linked to what your genetic sequences look like.

You are a geneticist – is this a runner?
No, absolutely not. Chemical analysis is interesting and so is drug development but the genomics thing is bizarre.

Would you visit an ayurvedic practitioner?
Personally I wouldn’t, but I would do yoga. I think there is a lot on the system of nutrition that makes a lot of sense. People go to alternatives when modern medicine doesn’t have an answer – they see a lot of parents of autistic kids coming in.

You describe an encounter with someone who said they had prayed to a goddess and their wife was cured of TB. How do you respond to statements like that?
They don’t have any other explanation. It’s something really interesting about India. Because it is so pluralistic on so many levels, most people are willing to accept more than one thing on an equal footing. So [they’d say]: “Maybe it was the goddess, maybe it was the medicines, we are not sure – but does it even matter because she is better now?”

Many of the initiatives to provide access to good healthcare seem to come from determined individuals and philanthropic organisations rather than the government. Does that frustrate you?
Yes, it is predominantly people’s own [efforts] – they have spotted a problem and made sacrifices or used their own money or got family money or started an initiative themselves. The government seems to be working for the public through supporting private hospitals but the money never filters back into the public system and so the government hospitals are dire and oversubscribed. The percentage of GDP going into healthcare is appallingly low, and while I was writing the book it dropped further.

One of the more dramatic folk remedies in the book involves swallowing live fish – tell me about that.
It is a cure for asthma – obviously! When I first looked at [the practitioners’] website, I couldn’t believe it – it was almost state-sponsored and sounded completely bonkers. They make a secret herbal formulation, they get live fish about the length of your finger and they stuff the herbs into its mouth and put the fish down your throat. The other bizarre thing is that it has be on a particular day every year at a certain time. I thought, these people are charlatans – this is ridiculous.

Did meeting them change your view?
I was surprised actually because they’re a really nice family and they’re doing this charitably. Something like 70-80,000 people come. The state actually gives a stadium over to this and the ministry of fisheries keep aside the fish for them. They are not trained as ayurvedic doctors. The point is, for a lot of people who are poor, if they see that a doctor will do something for free, they turn up. There’s a lot of opposition – people say this needs to be tested and question the government supporting it. It is the same for homeopathy: the government supports homeopathy and there is no evidence for that either. People will come to swallow fish for asthma with their inhaler in their pocket. Indians hedge their bets.

Does the inclusion of homeopathy and naturopathy in Ayush have a detrimental effect on the image of traditional Indian medicines?
I think so. There’s this idea that they are natural and they can’t cause any harm. Of course that’s not true: herbal remedies will have effects because there’s something in them. Homeopathy won’t – because there’s nothing in it, though it might prevent you being diagnosed with whatever it is that is really affecting you. I would drop those two, and look to things that have a professionalised system and some evidence and logic behind them.

What’s the biggest challenge for healthcare in India?
Funding is one major thing the government could do immediately. And you need to take into account cultural context: when you have tribal people who wrap their dead in white clothes then they’re not likely to feel comfortable with doctors and nurses wearing white clothes . A lot of doctors I spoke to said we need more textbooks that are written here for the Indian cultural context. And we need more doctors.

In the Bonesetter’s Waiting Room: Travels through Indian Medicine by Aarathi Prasad is published by Profile and the Wellcome Collection (£14.99). Click here to order a copy for £11.99