On a holiday to Kerala on India's south-western Malabar Coast, Shilpa Iyer decided to visit Kotakkal, a town that became famous after the establishment of Arya Vaidya Sala, Kerala's best-known centre for the practice of Ayurveda, in 1902.
Seven days later, she left the historical treatment centre after completing panchakarma, a cleansing and rejuvenating programme for the body, mind and consciousness. "There was nothing really wrong, but I was always busy with the demands of modern life and plagued with continual aches and pains,” Iyer says.
“So, I decided to focus on my own health." Panchakarma, a holistic Ayurvedic therapy, involves a series of detoxifying procedures.
It integrates herbal medicines, cleansing therapies, personalised diet plans and wellness activities to eliminate the root cause of disease, revive and rejuvenate the body, and ensure health and longevity. Iyer says she left "feeling lighter, healthier and better than ever before".
She isn't the only one who signed up for an Ayurvedic treatment in Kerala; the holistic system of medicine is a way of life in this coastal paradise. Derived from the Sanskrit words "ayur" (life) and "veda" (science or knowledge), Ayurveda translates to "knowledge of life" and originated in India more than 3,000 years ago. It is based on the ideology that health and wellness depend on a delicate balance between the mind, body, spirit and environment, and places great emphasis on preventive strategies rather than curative ones.
The ancient system of medicine is centred on the idea of universal interconnectedness between prakriti (the body's constitution) and doshas (life forces). Varied combinations of the five elements — aakash (sky), jal (water), prithvi (earth), agni (fire) and vayu (air) – create the three doshas.
Dr Gaurang Paneri, an Ayurveda practitioner, explains every person has the three doshas, vata, pitta and kapha, in varying strength and magnitude. "The predominant dosha determines their prakriti.
Diseases arise when doshas are affected because of an external or internal stimulus (typically linked to eating habits, lifestyle or physical exercise). Ayurveda works to ensure harmony between the three," he says.
Ayurvedic knowledge has been passed down through generations of practitioners across India. But Kerala is the state that's truly synonymous with Ayurveda.
Keralites are big believers and have been for centuries. Aware of the popularity of Ayurveda, the state government began positioning Kerala as a wellness destination way back in 1994, before the term even existed.
There has been no looking back. PB Nooh, the director of Kerala Tourism, says that Kerala is the only place in the world where Ayurveda is "practised to perfection".
"Most practitioners here hail from families where the knowledge has been passed from down over generations. Every little town and village in Kerala has an Ayurveda pharmacy, which showcases its popularity in the state."
Kerala is the first place in India to receive monsoon, and Keralites call the rainy season oushada maasam, "the medicinal season". "It is the time when they go in for annual rejuvenation treatments.
“Even the elephants in Kerala are given a break from their work schedule and fed with specially prepared medicinal food," Nooh says. He also notes that Kerala's moist climate and fertile soil is conducive for the growth of traditional medicinal plants and herbs used in the practice.
"The dense tropical forests of Kerala have a wealth of herbs and medicinal plants used to make the extracts and elixirs prescribed by Ayurveda," he adds. The small state has more than 100 Ayurvedic government-run hospitals, 800 Ayurvedic pharmaceutical factories and 800 Ayurvedic medicine dispensaries.
As many as 120 holiday resorts and private wellness centres offer specialised treatments such as kasti vvasti, an oil-based treatment for back pain and inflammation in the lumbosacral region; elakkizhi, a treatment with heated herbal poultices to tackles aches, pains and muskoskeletal trauma; njavara kizhi, a massage therapy for arthritis or chronic musculoskeletal discomfort; and shirodhara, a restorative therapy to ease stress and anxiety and that involves pouring warm, medicated oil over the forehead.
Most treatment centres offer therapies and treatments for a range of health issues, including immunity, mental health, anxiety, pain management, weight loss, skin and health care, sleep issues, psoriasis, eczema, eye care, arthritis, sciatica, gastric problems and paralysis. Dr Shiny Harish, an Ayurvedic doctor in Kotakkal, Kerala, explained: "The treatments typically include dietary changes, herbal medicines, massage therapies, poultices, meditation and breath exercises.
“Plants, herbs, oils and a few spices are used to manage symptoms, treat imbalances and create resistance." The fact that Ayurveda places great emphasis on preventive strategies and encourages the maintenance of health through close attention to balance in one's life, resonates with people tired of a fast-paced existence and the problems that brings.
According to Dr Reji Raj, general manager and senior Ayurveda consultant at Amal Tamara, a luxury Ayurveda resort in Kerala, Covid-19 also fuelled interest in the practice, both nationally and internationally, due to its focus on periodic cleansing to restore and maintain the body's delicate balance. In fact, Kerala has seen a 15% increase in the number of domestic travellers visiting the state for Ayurvedic treatments since November 2021.
And while international travellers have long flocked to Kerala for its beaches and backwaters, cuisine and ecotourism initiatives, the state is seeing a surge in visitors coming for wellness tourism at Ayurvedic centres. Demand is so high that in August 2023, the Indian government introduced the Ayush (AY) visa – a new category of visa to facilitate travel for foreign nationals seeking treatment under traditional systems of medicine.
(Ayush is an acronym for ayurveda, yoga and naturopathy, unani, siddha and homeopathy, the six traditional systems of medicine practised in India.)
"Ayush covers a gamut of indigenous and holistic healthcare systems that have flourished side-by-side in Kerala. People still seek solutions based out of these systems," Nooh says. Of these, Ayuveda remains the most popular.
According to a 2024 report by Market Research Future, the global Ayurveda market size, pegged at $8bn in 2022, is likely to grow from $9.2bn in 2023 to $26.16bn in 2032. "Knowledge of advantages (of Ayurveda), awareness about drawbacks of allopathy, accessibility and rising disposable income" are driving demand, the report says.
