Neopicrorhiza scrophulariiflora is widely used as a substitute for Picrorhiza kurroa, commonly known as Kutki, which is now classified as Endangered on the IUCN Red List of Threatened Species.

In Basgo, an Amchi sat Garima down with a very sugary cup of chai, and for three hours they debated something another Amchi at the Ladakh headquarters had told her a week earlier: “If a plant goes extinct, we can find a replacement for it in some other plant.”

Garima rarely argues with government officials. But she has no qualms in having long arguments with people whose lives, practices, and knowledge systems are affected when a plant disappears. Anecdotally, people across the region have spoken to Garima about plants that were once essential to traditional medicine, including for surgeries and specific ailments. When these plants disappeared, practitioners had to travel farther and higher to find them—or abandon certain treatments altogether.

Extinction means different things to different people along the long chain that sustains a knowledge system. For some, it is a change in the availability of a species. For others, it is the loss of a medicine, a practice, a piece of knowledge, or the ability to pass that knowledge on.