Ayden Toleman and Staff

For Theirs is
the Kingdom

World Medical Mission - A Ministry of Samaritan's Purse

Asecond-grade Sunday school classroom in Edmonton, Canada, holds special significance in the lives of Dr. Hudson and Alisha Kroeker. It was in that room where the two first met, as 8-year-olds. It wasn't love at first sight; that came later when they were reacquainted in high school and attended college together at MacEwan University.

Neither can recall exactly what they learned in that long ago Sunday school class, but it's fairly safe to assume that they heard stories about Jesus healing the sick, the blind, and the disabled. Over the years those seeds of faith took root in their hearts. Both became followers of Jesus Christ, compelling them to want to serve others using the medical giftings God had given them.

"Hudson and I have always wanted to do a mission trip together," said Alisha, a surgical nurse who assists in cardiac and oncological procedures. "We have skills that are greatly needed on the mission field, and we felt called to go on a short-term trip."

Dr. Hudson and Alisha Kroeker

Hudson and Alisha Kroeker's trip to Niger with World Medical Mission was their first missions experience as a couple.

The couple married in 2018. After their original plans for a summer 2020 trip were halted by COVID-19, they contacted World Medical Mission again last year.

Unbeknownst to the Kroekers, Galmi Hospital in Niger had reached out to World Medical Mission a few months before with an urgent request for an optometrist—Hudson's specialty. Our staff told hospital administration we rarely have optometrists to apply to serve, but we would let them know if anyone did.

A brief time later, in January 2022, Hudson and Alisha were on a plane heading to Galmi for their first missions experience and their first trip to Africa.

"We knew that Niger was very impoverished and that there would be a lot of need there. We wanted to be challenged, to be put into an uncomfortable position," Hudson said.

"Going to Niger, it did exactly that."

A Change in Perspective

In 2021, the United Nations ranked Niger as the least developed country in the world based on its Human Development Index (HDI). An estimated 43 percent of the population lives in poverty, earning less than $1.90 per day, as reported by concernusa.org. Twenty percent of Nigeriens are not able to meet basic daily food and nutritional needs.

"If there is something beyond Third World, Niger would fall into that category," said Alisha.

The staff at Galmi Hospital taught the Kroekers an oft-repeated word in the Hausa language: "wahala." It means "suffering," but for the people of Niger, the depth of meaning implies more than just a momentary hardship or setback. For them, to live is to suffer.

Alisha Kroeker with patient

Alisha Kroeker, a surgical nurse, pictured with a member of the anesthesia staff at Galmi Hospital in Niger.

A 30-year-old woman came to Galmi to have removed what Alisha described as a “grossly enlarged” thyroid. The typical procedure would involve taking out the entire thyroid and then placing the patient on hormone replacement medication (which costs about $1.00 a day in Niger). That cost may sound like an amazing bargain compared to prices in North America, but for this woman, it was beyond her financial ability.

"So in turn her arm got necrotic, and when she came to us in the operating room, she was left with a forearm with bones and muscles exposed."

The surgeon, an African medical resident who understood the patient's plight, agreed to leave some of the woman's thyroid intact so she could continue to produce hormones.

"The resident told me that medical textbooks do not account for poor people in Third World countries,” Alisha said. “Post-operative patients in Niger have no access to wheelchairs, crutches, canes, regular medication, home care, physical therapy, or even a pillow. I never thought I would be thankful for something as simple as a pillow."

Restored Vision

Hudson's main objective was to set up an eye clinic to primarily treat hospital staff, their families, and retired staff. Most of them had not been examined by an eye doctor in years.

"I think the last eye professional to work at Galmi was an ophthalmic nurse, and that was maybe eight years ago," he said.

The hospital had a slit lamp that the nurse had left behind, but little else related to optical equipment. So Hudson brought his own supplies—a 50-pound auto-refraction machine to screen patient prescriptions and measure eye pressure, a retinoscope, various kinds of eye drops, and 350 pairs of glasses.

Eye exam equipment
Dr. Hudson analyzing a patient

ABOVE LEFT: Pre-screening of patients was handled by assistants who received training from Hudson Kroeker. ABOVE RIGHT: Hudson Kroeker performs a patient exam in the eye clinic.

He trained three people to assist him in pre-screening tasks, giving him more time to focus on diagnosis and treatment. Some patients only needed new glasses to improve their vision, while others discovered their vision was impaired due to glaucoma, cataracts, or corneal diseases.

"I had to tell some of the patients that there were no magic pills to save their vision," he said. "I'm not trained to do surgeries, and they would probably have to go to Niger's capital to find an eye specialist. The costs of travel and the operation make that option improbable for most people."

For the majority who Hudson was able to help, the results were significant. One of the hospital chaplains received encouraging news when he visited the eye clinic. The man's eye exam revealed that he had moderate glaucoma. Thankfully, the condition was caught early. The chaplain praised God for the eye drops Hudson gave him that will help preserve his vision and maintain his quality of life.

Short-term volunteers working for World Medical Mission

Serve With Us

World Medical Mission is looking for Christian doctors, dentists, nurses, and other healthcare professionals to serve on short-term volunteer assignments at our partner mission hospitals and clinics. We also offer two-year placement opportunities through our Post-Residency Program for those who are completing residency and feel called to a career in medical missions. For more details, contact us at wmminfo@samaritan.org or (828) 278-1173.

Apply Now

"Let the Little Children Come to Me"

In addition to being one of the poorest nations in the world, Niger's population is one of the most youthful. An estimated 58 percent is below the age of 18, according to UNICEF.

Malnutrition, inadequate sources of clean water and sanitation, and limited access to healthcare all contribute to the epidemic of sickness and suffering for the country's most vulnerable group of people.

"There are a lot of children here in Niger, but little childhood," said Alisha.

Streets of Niger

Niger has the 11th highest mortality rate in the world for children under the age of 5.

Among the patients she saw were a “never ending flow” of babies and children with typhoid, resulting in intestinal perforation that requires surgery. More often than not, families wait too late to bring their little ones to the hospital. Such deaths are all the more tragic because they are preventable.

Others are left disabled or permanently damaged when parents opt to take a child to a traditional village healer whose services may be cheaper than a hospital visit, but ultimately lead to more harm.

While working in the operating room, Alisha saw patient cases that both baffled and horrified her. One day in February was especially heart-wrenching, as she relayed the stories of two pediatric patients in an email to family and friends in Canada:

"Where there is light, darkness cannot exist, and we saw so many moments of hope and life."

"The first patient that I helped that day was a premature 3-week-old baby who had flesh-eating bacteria on her whole abdomen. I assisted the medical resident with the child's surgery. Her head was covered with little bumps, which the resident explained was a bacteria causing a skin infection, from an unclean living environment. Her cry was so quiet and fragile sounding. I picked her up and just held her, and she started to settle. She had no parents, just an aunt or older sister looking after her. This emotionally tore me apart, because this little baby is so innocent and small, and there was nothing I could do about what she is going home to. There's a chance she won't make it to six months.

"The next patient I had was a 4-year-old girl. She got an infection on her hand a few weeks ago. Instead of taking her to the hospital here, her parents brought her to a traditional healer. This healer thought it would be a good idea to put splints of wood in the little girl's arm, and cut off the blood supply. So in turn her arm got necrotic, and when she came to us in the operating room, she was left with a forearm with bones and muscles exposed. I helped the medical resident as much as I could, but we had to amputate above the affected area. The suffering of this girl is immense, and my heart grew heavier than I thought it could."

Children in Niger. 12.5 Million under 18 Yeard old. 11th Highest mortality rate under age 5. 48% of children live under the monetary poverty line. 76% of girls are married before the age of 18. 20% do not complete primary education & most don't complete lower secondary school.

In Matthew 19:14 (NIV), Jesus instructed His disciples, "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these." Now Alisha has a new perspective on that verse when medical intervention fails.

"I've always imagined Jesus sitting on the ground, welcoming children to sit with Him and be with Him," she said. "Now I also see that this verse could describe Jesus welcoming little ones permanently back into His arms and into heaven, where they no longer experience suffering and pain, hunger and thirst."

The Gift of Gratitude

In the midst of such anguish, the staff and patients alike demonstrated a remarkable resilience that deeply impressed the Kroekers. Their medical facility may have lacked state-of-the-art technology, but there was no shortage of praise and gratitude to God for what they do have.

Hudson treated about 300 patients during the four weeks he and Alisha spent in Niger. Many of those were current staff who were delighted to receive a new pair of glasses and enjoy improved vision.

"Where there is light, darkness cannot exist, and we saw so many moments of hope and life," said Hudson. "These people are immersed in serving Christ and giving of themselves. It's inspiring."

Alisha agrees. Whenever they prepared to do surgery, the medical residents and anesthesia team paused to pray for God's divine power to be demonstrated in the life of each patient. She rejoiced over those answers—like a 16-year-old who had a chest tube inserted to drain fluid from a lung ravaged by tuberculosis.

Dr. Hudson and other doctors helping patient

Galmi Hospital reopened its Pan-African Academy of Christian Surgeons (PAACS) program in 2012.

After over 2.6 quarts of fluid was removed, the youth's breathing relaxed and a big smile lit up his face. In a frail voice, he looked up at Alisha and said in English "Thank you."

"It was wonderful to see the immediate relief and expansion of his lungs once again. It brought tears to my eyes to see his thankfulness."

Such examples of humble gratitude have convicted their own hearts and cemented their desire to go on future mission trips.

"It becomes a choice to be grateful. I take this choice back home to Canada, and I will hang onto it always," Alisha reflected. "Hudson and I made a promise to one another: to never let the other person forget that we have a choice to be grateful."

And that's a promise worth keeping.