The Hope Chest explores the lives of three women that all cross paths with each other. The first of the women, from Pakistan, is Rani. Although she is from a third world country, she is upper middle class, and lives a pretty easy life. The second woman is Rani's family gardener's daughter, named Reshma. Both of these women live in the city of Lahore.
The third woman of the novel isn't from Pakistan, instead a visitor from London, United Kingdom. Rani is rushed to a hospital in London where she is treated for Anorexia, and this is where Ruth, the Londoner, and Rani meet. Reshma, still in Pakistan, is now thirteen years old. This means she is in the prime age to be considered for a mate. A man, about thirty, marries her because she desperately needs the money.
The novel particularly emphasizes the choices that a woman has to make when she is poor. In Pakistan, where women are still considered only fit for the house, Reshma must find what is best for her and her husband. These things must both meet his approval and fit the family budget - at first, it seems impossible. However, after grappling with the choices of the real work, Reshma finds a way to make everything work out just fine.
Ruth and Rani, at the hospital in London, also have many choices to make. Rani, who is not in the best state of mind, wonders if she will become insane for the rest of her life. Internally, she make the decision to push through her illness as long as she can. Ruth, despite having other responsibilities, stays with Rani to help her through this especially hard time.
Each of the women in the novel (although Reshma is only thirteen, she is considered a woman in Pakistan), has to go through a considerable amount of trauma that they would never have seen if they were cooped inside a home like the average middle class individual. However, they each decide that these hard decisions and experiences were for the best, and made each of them a better person, more equipped to handle the challenges that life throws at them.
