Cremation fears leave empty beds in Liberia

Associated Press

MONROVIA, Liberia

Even as Liberians fall ill and die of Ebola, more than half the beds in treatment centers in the capital remain empty, an unintended consequence of the government’s order that the bodies of all suspected Ebola victims in Monrovia be cremated.

Cremation violates Liberians’ values and cultural practices, and the order has so disturbed people in the West African nation that the sick often are kept at home and, if they die, are secretly buried, increasing the risk of more infections

President Ellen Johnson Sirleaf issued the cremation decree for Monrovia and the surrounding area in August, and the government has brought in a crematorium and hired experts. The order came after people in neighborhoods of the capital resisted burials of hundreds of Ebola victims near their homes.

Since then, a recent analysis of space at Ebola treatment centers shows that of 742 beds available, more than half — 391 — were vacant, said Assistant Health Minister Tolbert Nyenswah, who heads the government’s Ebola response.

“For fear of cremation, do not stay home to die,” Nyenswah admonished Liberians at a news conference last week.

In her statement declaring the state of emergency and the cremation order, Sirleaf acknowledged the edict runs contrary to national tradition. “Ebola has attacked our way of life,” she said.

That way of life includes honoring deceased ancestors. On the second Wednesday of March each year, Liberians flock to cemeteries to honor their deceased loved ones on a public holiday known as National Decoration Day, scrubbing the headstones of relatives, clearing away brush from graves and decorating them with flowers and other mementoes.

In many parts of Liberia, tradition also has called for relatives to handle the bodies of loved ones before burial. Bodies are kept in the home for days or weeks, during which time people honor their loved ones by dancing around the corpse, washing it and cutting and braiding the hair. Before burial, church congregations also pray over the body.

Since the latest outbreak of Ebola, these burial customs have been ordered halted when it comes to victims of the deadly virus because of the dangers they pose. The Ebola virus is spread through the body fluids of an infected person and can endure in corpses, posing a danger to those who handle them.

Guidelines issued by the Centers for Disease Control and Prevention in the United States call for the bodies of Ebola victims to be handled only by those trained in handling infected human remains who are wearing the proper protective equipment. Bodies should be wrapped in plastic shrouds, then cremated or promptly buried in hermetically sealed caskets, the CDC says. The first person diagnosed with Ebola in the United States — a visitor from Liberia, Thomas Eric Duncan — died in Dallas this month, and his body was cremated.

In Liberia, the cremation edict in the capital and the order that Ebola victims elsewhere be buried in body bags in unmarked graves without relatives present have been met with resistance. Many find it hard to accept that they will never see the graves of those lost to the disease.

“We know cremation is not our culture in our country,” Nyenswah said. “But now we have disease, so we have to change the way we used to do business.”

At least 4,665 people have been infected with Ebola in Liberia and 2,705 have died, according to the World Health Organization, which says there probably are more cases and deaths.