This article is about the preservation and development of the localized form of Tibetan medicine known as amchi medicine or Sowa Rigpa in the Himalayan region of Ladakh. The article discusses the traditional position of the amchi, the practitioner of this system of medicine, and how that position has changed over time. The rapid development of Ladakh in the last few decades has brought about fundamental changes in traditional social and economic patterns. These changes have led to challenges for the amchi system and various responses to overcome these challenges. The article focuses primarily on the work of one amchi, Tsewang Smanla, who is also a coauthor of the article. Smanla's training and practice are discussed, along with the various projects he has directed that aim to support and develop the amchi tradition in Ladakh.

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