Dukkha (Pāli; Sanskrit: duḥkha; Tibetan phonetic: dukngal) is a Buddhist term commonly translated as "suffering", "stress", "anxiety", or "dissatisfaction". Dukkha is identified as the first of the Four Noble Truths.

Within the Buddhist tradition, dukkha is commonly explained according to three different patterns or categories. In the first category, dukkha includes the obvious physical suffering or pain associated with giving birth, growing old, physical illness and the process of dying. These outer discomforts are referred to as the dukkha of ordinary suffering (dukkha-dukkha). In a second category, dukkha also includes the anxiety or stress of trying to hold onto things that are constantly changing; these inner anxieties are called the dukkha produced by change (vipariṇāma-dukkha). The third pattern or category of dukkha refers to a basic unsatisfactoriness pervading all forms of life, due to the fact that all forms of life are impermanent and constantly changing. On this level, the term indicates a lack of satisfaction, a sense that things never measure up to our expectations or standards. This subtle dissatisfaction is referred to as the dukkha of conditioned states (saṃkhāra-dukkha).

Ayya Khema (August 25, 1923 - November 2, 1997), a Buddhist teacher, was born as Ilse Kussel in Berlin, Germany, to Jewish parents. Khema escaped Nazis persecution during World War II. She eventually moved to the United States. After travelling in Asia she decided to become a Buddhist nun in Sri Lanka in 1979. She was very active in providing opportunities for women to practice Buddhism, founding several centers around the world. In 1987 she co-ordinated the first ever International Conference of Buddhist Nuns. Khema wrote over two dozen books in English and German, including her autobiography: I Give You My Life.

Ayya Khema was born in Berlin in 1923 to Jewish parents. In 1938, she escaped from Germany with two hundred other children and was taken to Glasgow, Scotland. Her parents went to China and, two years later Ayya Khema joined them in Shanghai. With the outbreak of the war, however, the family was put into a Japanese prisoner-of-war camp where her father died. She later married, had a son and a daughter, and now has four grandchildren.