From the New York Times-bestselling author of Cutting for Stone comes a stunning and magisterial new epic of love, faith and medicine, set in Kerala, South India.

Spanning the years 1900 to 1977, The Covenant of Water follows a family in southern India that suffers a peculiar affliction: in every generation, at least one person dies by drowning - and in Kerala, water is everywhere.

At the turn of the century a twelve-year-old girl, grieving the death of her father, is sent by boat to her wedding, where she will meet her forty-year-old husband for the first time. From this poignant beginning, the young girl and future matriarch - known as Big Ammachi - will witness unthinkable changes at home and at large over the span of her extraordinary life, full of the joys and trials of love and the struggles of hardship.

A shimmering evocation of a lost India and of the passage of time itself, The Covenant of Water is a hymn to progress in medicine and to human understanding, and a humbling testament to the hardships undergone by past generations for the sake of those alive today. Imbued with humour, deep emotion and the essence of life, it is one of the most masterful literary novels published in recent years.