I first met Kay Warren over dinner at a restaurant in Boston’s North End. At the time, I was coordinating an HIV/AIDS treatment access campaign for a nonprofit human-rights organization. Warren is the wife of the famous Evangelical pastor and author, Rick Warren. His best-selling The Purpose Driven Life had topped most records for nonfiction sales in the United States, yet most of my friends and colleagues had never heard of it. I had approached the meeting with the hope of discovering some common ground with Kay Warren in terms of political goals. She was not interested in talking politics, or in working with a secular human-rights organization, but she was interested in sharing our stories. Her narrative was a compelling one about how God had reached down and “seriously disturbed” this famous pastor’s wife.

Dangerous Surrender details her journey from “comfortable” ignorance to a heartbreaking awareness of third-world suffering. While tracing her personal journey, Warren guides readers through ever-deepening stages of surrender in their personal relationship with God, a process that she promises will awaken them to the purpose of suffering in their lives and move them toward Christ-like compassion and response to the suffering of others. Warren, who lives in Orange County, California, writes primarily for well-to-do American Christians. Her point is to help them rearrange their comfortable lives, priorities, and finances in order to serve those living in what she calls the “suffering world.”

Warren’s own transformation begins in 2002 when she read a magazine article describing the 12 million children orphaned by HIV/AIDS worldwide. The article dispelled her misconception that “everyone who has HIV is gay.” After a period of “anguished wrestling with God,” she decided to do something about the AIDS crisis. This decision was the start of a life-altering conversion. “Like the apostle Paul knocked off his donkey on the road to Damascus,” she writes, “I was changed by my encounter with truth.” That eventually led her to visit people living with HIV/AIDS in Africa and Asia and, together with her husband, to launch the P.E.A.C.E. Plan, a mission to end what the Warrens call the Five Global Goliaths: spiritual emptiness, corrupt leadership, poverty, AIDS, and illiteracy.

Soon after launching the plan, Kay Warren’s experience of suffering suddenly got very personal. She was diagnosed with breast cancer in 2003, then skin cancer the following year. Though the treatments were excruciatingly painful, she believes that God put her through “the crucible of cancer” to purify her character and make her life a “sacramental offering” for others. An anecdote demonstrates Warren’s trust in what she describes as the purpose behind God’s “crushing fingers.” In 2004, after surviving her first bout with cancer, Warren visited a woman in Cambodia who was dying of AIDS. She found her in a sweltering “little bamboo house.” The woman was surrounded by the women of her church who were caring for her in her final hours. In their meeting, the dying woman told Kay about “the nearness of God,” and this encounter proved to be a breakthrough for the American. It taught her to recognize her own capacity to empathize with the sick, a gift made possible by her experience of cancer. “It was a different illness, and I was halfway around the world,” Warren writes, “but I could identify with a fellow sufferer in a whole new way. I got it.” But there was something else. The Cambodian woman’s steadfast faith and the presence of her loving community illuminated for Warren how suffering can serve similar purposes in vastly different circumstances and locales: “I could...identify with the blessings hidden in the messiness of suffering—the ‘gold’ it produced,” she writes. “I figured out that life’s brevity and fragility make it precious and worth living to the full extent of my passions and his purposes. These are lessons you only learn through pain.” Unfortunately, while HIV/AIDS had made the love of God and neighbor especially clear in the case of this remarkable Cambodian woman, it had not solved any of her other problems. For her and for most of the world’s poor, knowledge of “life’s brevity” is hardly a revelation. For Warren, however, this woman’s prayerful death was a discovery.

Had Kay Warren not experienced her own agonizing treatments for cancer, it might be easy to fault her for romanticizing the suffering of others. But one can hardly judge her for finding some meaning in her own suffering, especially since it inspired her to serve others. Still, Warren’s personal experience of illness and her certainty that God had sanctified it allow her to too easily identify her sufferings with those who live in completely different circumstances. Perhaps that is why this book does not express any moral outrage at the fact that while Warren herself had access to the best medical care in the world, the Cambodian woman was dying from a treatable disease. It is one thing to receive a potentially fatal diagnosis in Orange County, another to receive it in the context of grinding poverty.

Kay Warren’s concern for those suffering the effects of poverty and disease is genuine, yet Dangerous Surrender often seems to position “the suffering world” as a character in her own narrative—an undeveloped character at that. Her admonition that readers find a way to get themselves disturbed, that they do “anything that puts [them] in direct contact with hurting people” seems to set up the “suffering other” as a catalyst for her American readers’ spiritual growth. Her plan for helping those who suffer relies heavily on a theology of presence, which is certainly an important component of an AIDS ministry, especially in places where an HIV diagnosis often spells ostracism. But going to an exotic land to get “disturbed” can easily devolve into a kind of spiritual safari.

It would be difficult to overestimate the value of Rick and Kay Warren’s effort to shift not only their own church but the entire American Evangelical community in the direction of service to those living with HIV/AIDS, a condition many Evangelicals once considered God’s judgment on a sinful lifestyle. But HIV is not simply God’s wake-up call to lazy Christians. The virus follows fault lines that include marginalization, oppression, violence, inequality, and poverty. An honest analysis of the causes of the HIV/AIDS pandemic requires confrontation with these larger, very earth-bound forces of injustice. Without pragmatic attention to the structural inequalities that make people vulnerable to HIV, even the best intentions can seem, in Paul Farmer’s words, “like so much abstract piety.”

Related: Melissa M. Matthes reviews The Invisible Cure: Africa, the West, and the Fight against AIDS