For 43 years Australian couple Ken and Jocelyn Elliott built their hospital, brick by brick, bed by bed, a white surgery against the red dust of Burkina Faso in west Africa.
Their toil was a daily grind against the economic realities of their adopted home, no X-rays, no doctors, and few canvas stretchers on bare concrete floors.
The 80-year-old Dr Elliott was the only surgeon for 2 million people in the area. 
At 4am on Saturday al-Qaeda-linked extremists stormed the Perth couple's house near Baraboule, dragged them from their beds, kidnapped them and put them on their way to the border with Mali, according to news agency AFP. Dr Elliott left his glasses behind, a close friend told the Independent.
As the Department of Foreign Affairs and Trade scrambles to get diplomats from Ghana 1100 kilometres away to negotiations in the area, Dr Elliott and his wife Jocelyn (pictured) find themselves in the centre of a pan-African-Middle Eastern power play.
A spokesman for Malian militant group Ansar Dine, Hamadou Ag Khallini, told AFP that the couple were being held by jihadists from the al-Qaeda-linked "Emirate of the Sahara," who operate in northern Mali as a branch of the al-Qaeda in the Islamic Magreb.
Rivals to Islamic State through their al-Qaeda affiliation, AQIM specialises in kidnappings, trafficking arms and drugs. All three help fund their terrorist activities, according to the US Department of State.
"AQIM's aggressive efforts to turn a profit by kidnapping, smuggling, and other criminal activities set it apart from other al-Qaeda affiliates," a report from the US International Security and Defense policy centre found last year.
As Islamic State's visibility has increased, so has AQIM's own violent campaigns on new frontiers.
On Saturday they hit two targets. Hours before they took the Elliotts, the group claimed responsibility for killing at least 27 people from 18 different nationalities on the same night in Burkina Faso's capital Ouagadougou.
In this melee, somewhere in the barren west-African desert on their way to Mali is the octogenarian couple from Perth, European intelligence sources told AFP.
They have left behind a community visibly devastated by the loss of their medical and spiritual guides of more than 40 years.
"What are these kidnappers thinking?!" wrote one of their supporters, Abdoulaye Dicko. "Dr Elliott is not a tourist but a saviour of life and that of the poor."
"This is the life of a man who has denied inevitable disease for millions of people," said former patient Roger Bemahoun.
The journey of the Christian couple started seven decades ago on a Western Australian farm.
At 15 Dr Elliott dropped out of school and went to work on the land, skills that would enable him and his wife to survive in the harsh Burkina Faso climate.
By 21 he had been accepted to medical school, had stints with the Fremantle hospital and London's school of Tropical Disease. Flights over the Kalgoorlie desert with the Royal Flying Doctor would follow.
But it was in another red landscape that Dr and Mrs Elliott would find their calling.
"We were very impressed by the isolation, both spiritually and medically," Dr Elliott said in an interview with the friends of Burkina Faso charity.
"In the early days one of the challenges was to keep things running and pay the wages."
For 43 years they would stay, building the centre from one bed to 120, from one surgery a month to 150, without ever appealing for money as a matter of policy.
The couple never wanted to leave their patients behind and only returned to Australia once every five years to renew their medicare entitlements, knowing full well how hard it would be to find a qualified replacement for the time they would be away.
"I suppose one of our biggest challenges is staff," said Dr Elliott. "Getting trained national [Burkina Faso] staff is an impossibility."
Growing into their eighth decade, the couple launched an appeal in 2010 for someone to take over their hospital.
But now, patients lie alone with not a single surgeon to treat them.