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At 4am on Saturday, Australian couple Ken and Jocelyn Elliott were abducted from their home in northern Burkina Faso and taken across the border into Mali.
Inside Ken and Jocelyn Elliot's hospital in Djibo
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Inside Ken and Jocelyn Elliot's hospital in Djibo
The hospital that the kidnapped couple set up now has room for 120 patients and is the only reliable surgical service for up to 2 million people. Credit: Global Business Solutions Inc.
The kidnappers were from an extremist group called Emirate of the Sahara, a branch of al-Qaeda in the Islamic Magreb. Hours earlier, they claimed responsibility for killing at least 27 people in Burkina Faso's capital Ougadougou.
According to the Elliott family, as of Sunday, no reason was given for the kidnapping but the group is known for aggressively seeking revenue through ransoms as well as trafficking and other criminal activities.
The focus now shifts to what can be done to save them. What options do the family and authorities have to secure the release of the elderly pair of charity workers, who have operated in the region for more than 40 years?
Making contact and negotiating
The best thing the Australian government can do is get out of the way.
That's according to security specialist Clive Williams, who says the government's no-ransom policy and lack of relevant expertise mean they have "very little to offer".
"It's better for them to disengage from any contact with the kidnappers and let a professional negotiator do the work for the family," Professor Williams said.
Private contractors with local relationships, knowledge and expertise can be arranged through organisations such as Hostage UK. The British government's policy is to hand over a situation to private negotiators as soon as they establish it's a kidnap-for-ransom.
For now, Australian authorities such as the Department of Foreign Affairs and Trade and the Australian Federal Police will be seeking to make contact with the extremist group through local authorities in Mali and Burkina Faso, to liaise with a third party such as militants Ansar Dine, who have previously spoken on behalf of Emirate of the Sahara.
The no-ransom policy means government is limited to negotiating without promising financial gain, undertaking a rescue operation, outsmarting hostage takers or stepping back and enabling the family to negotiate through private firms.
When governments remain involved, captors can believe they will secure a larger ransom.
In a 2011 Senate inquiry into the government's responses to overseas kidnapping, DFAT admits its no-ransom policy limits what it can do.
"The often extensive assistance we provide to kidnap victims and their families is within the context of this clear no-ransom policy," they said.
"We will provide strong consular support. We will also draw on our own resources, alliance, intelligence information and relations with other governments, but the no-ransom policy clearly puts limits on our involvement."
It is possible, but unlikely, for a successful outcome to be negotiated without a sizeable ransom payout.
It is down to the Elliott family to provide enough money to satisfy the militants. This can be a significant challenge.
Hostage takers in the region believe that all Westerners are very wealthy, which is true when compared to their own socio-economic status. However, this leads them to demand millions of dollars that most families do not have.
Ken Elliott is 'part of our community'
The community of Djibo in Western Africa's Burkina Faso are shocked by the abduction of their Australian doctor Ken Elliot, says former resident Dicko Seydou.
Professor Williams says this is where wealthy benefactors can be essential.
In 2008, Australian photojournalist Nigel Brennan was kidnapped by Somalian insurgents and was released a year later when a payment of $1.3 million was secured with the help of a private security firm. This was partially enabled by $500,000 from philanthropist Dick Smith and $100,000 from former Greens leader Bob Brown.
Testament to the challenge of funding a ransom payment is the plight of a Swede and South African held by the same militant group in Mali since 2011.
The government stands by the longstanding position that financing ransoms encourages further kidnappings and more outrageous demands. This policy is shared by the United States, New Zealand, Britain and Canada.
Security firm Clayton Consultants advises that the kidnap-for-ransom industry remains lucrative, not being vulnerable to "volatile upswings and downswings of market conditions".
"Not only is it profitable, but when planned properly, it requires very little investment for a high yield of return."
An armed rescue operation is high-risk - less safe than negotiating an outcome and requiring extensive local intelligence and expertise.
It is very easy for hostage takers to kill their prisoners before they are rescued and the only country with trusted capability in the region is France, a former colonial power.
In 1998, Sydney accountant Andrew Thirsk was killed in a bungled rescue attempt. He was caught in a shoot out as Yemeni security forces sought to retrieve him from Islamic militants. Another hostage, Catherine Spence, survived unharmed.
Conversely, a Dutch man being held by Emirate of the Sahara alongside the Swede and South African was rescued last year by French special forces.
In 2005, Australian engineer Douglas Wood was successfully rescued from Iraqi insurgents when local and US military forces conducted a surprise operation.
The Defence Force and DFAT agree that, while available, a military option is rarely feasible or advisable.
"This is due to safety concerns for both the hostage and Defence personnel, as well as complex practical and legal issues preventing an operation in another country," DFAT said in 2011.