For 43 years, Ken and Jocelyn Elliott built their hospital, brick by brick, bed by bed, a white surgery stark 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, a few canvas stretchers on bare concrete floors.
The 80-year-old Dr Elliott, from Perth, was the only surgeon for 2 million people in the area. At 4am on Saturday, al-Qaeda linked extremists stormed the couple's house near Baraboule, dragged them from their beds and headed towards the border with Mali, Agence France-Presse reported.
In a statement released on Sunday, a spokesman for the family said: "Recent news from the country indicates an alleged abduction of Ken and Jocelyn on Friday night, however no reason is yet given for this and their whereabouts is still unknown."
As the Department of Foreign Affairs scrambled diplomats from 1100 kilometres away in Ghana, the couple find themselves at the centre of a pan-African-Middle Eastern power play.
A spokesman for Mali militant group Ansar Dine, Hamadou Ag Khallini, told AFP the couple were being held by jihadists from the al-Qaeda linked "Emirate of the Sahara", which operates in northern Mali as a branch of al-Qaeda in the Islamic Maghreb (AQIM).
Rivals to Islamic State through their al-Qaeda affiliation, AQIM specialise in kidnappings and trafficking arms and drugs. All three help fund their terrorist activities, according to the US State Department. The group claimed responsibility for killing at least 27 people on Friday in Burkina Faso's capital, Ouagadougou.
The kidnapping has left behind a community 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."
A former patient, Roger Bemahoun, said: "This is the life of a man who has denied inevitable disease for millions of people."
The journey of the devoutly Christian couple started seven decades ago on a West Australian farm. Dr Elliott dropped out of school at the age of 15 and went to work on the land. By 21 he had been accepted into medical school. Stints with Fremantle hospital, the London School of Hygiene and Tropical Medicine, and the Royal Flying Doctor Service would follow before they moved to Burkino Faso.
"We were very impressed by the isolation, both spiritually and medically," Dr Elliott said in an interview with The Friends of Burkina Faso charity. "When we first came, we came with nothing."
They would stay for 43 years, never once appealing for money as a matter of policy.
"They have dedicated their lives to providing medical relief to people in the remote northern area of Burkina Faso," the family said on Sunday. "Their commitment to the local people is reflected in the fact that they have continued there with only a few holidays since 1972. They are held in high esteem by the local people."