Survival is definitely one of the themes of the novel, and the art of surviving becomes an essential part of the lives of Laila and Mariam. In addition to the war which wages throughout Afghanistan for years, the two women face the threat of injury or death on an almost daily basis from their abusive husband, Rasheed. Mariam's mother, Nana, has already struggled with the daily rigors of surviving the poverty of her own life, living in a simple hut just a few miles from Mariam's wealthy father. Nana takes the easy way out, hanging herself rather than face a life without her daughter.
The women face the hardships of starvation, imprisonment, and psychological cruelty during their time under the roof of husband Rasheed, who also savagely beats them. Laila is forced to accept Rasheed as a mate after her own parents are killed in an explosion, leaving her with little other way of surviving on her own. Mariam eventually dies at the hands of the Taliban, refusing to implicate Laila in Rasheed's death so that her life may continue.
Other characters must also deal with the threat of an early death in Afghanistan. Tariq, who has already lost a leg to the war, is forced to become a drug mule; he survives his stay in prison and returns to Kabul to find his true love, Laila.