MONROVIA, Liberia (AP) — Even as Liberians fall ill and die of Ebola, many beds in treatment centers are empty because of the government's order that the bodies of all suspected Ebola victims in the capital be cremated, authorities have determined.
Cremation violates values and cultural practices in the western African country. The order has so disturbed people that the sick are often kept at home and, if they die, are being secretly buried, increasing the risk of more infections.
President Ellen Johnson Sirleaf of Liberia decreed in August that the bodies of Ebola victims in the Monrovia area be cremated. The government 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.
A recent analysis of bed space at Ebola treatment units concluded that out of 742 spaces, 351 were occupied and 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 urged Liberians at a news conference.
In her statement declaring the state of emergency and the cremation order, Sirleaf said: "Ebola has attacked our way of life."
That way of life includes honoring deceased ancestors.
In March, the second Wednesday of the month is National Decoration Day, a public holiday during which people flock to cemeteries to clear brush from the graves of relatives, and scrub and decorate headstones.
Cremations in the capital, and burials of Ebola victims in body bags outside Monrovia without relatives present, means there won't be a place to honor deceased relatives. Decoration days will come with many people not knowing where the remains of their loved ones are, or knowing they were cremated and that their ashes were not recovered.
Many will 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."
The World Health Organization says at least 4,665 people have been infected with Ebola in Liberia and that 2,705 have died. WHO says there probably are more cases and deaths. Nyenswah said many people are remaining home to die instead of reporting for treatment.
"We understand that there are secret burials taking place in the communities," he said. "Let's stop that and report sick people and get them treated."
Outside the capital, those who are believed to have died of Ebola are buried in body bags.
Amid the new regulations, mortuaries and casket makers have lost business.
Caskets are on display at the Talented Brothers Casket Center. Titus Mulbah, a proprietor, was disappointed to learn that a man who approached was a reporter, not a potential customer.
"For the last two months it has been difficult to sell even one casket a day," Mulbah said. "And this is all because all bodies now are considered Ebola bodies, as if other diseases are not killing people here."
There have been complaints that people who died of something other than Ebola have been cremated or buried anonymously.
Television journalist Eddie Harmon said the body of his sister-in-law was hastily added to the bodies of Ebola victims and cremated, even though the family believes she died of hypertension.
"It is still paining us today because it was unjust and unfair," he said.
In neighboring Sierra Leone, families often picnic in cemeteries and clean graves on New Year's Day.
Sierra Leone has suffered 1,259 Ebola deaths by the latest WHO count. Unlike Liberia, the government has not ordered cremations. Ebola treatment units in Sierra Leone have often been full.
Still, there is the possibility that loved ones might be buried in unmarked graves and some families observe traditional practices in which mourners wash and lay hands on the body. Ebola is spread through contact with bodily fluids.
Anthony Banbury, head of the U.N. Mission on Ebola Emergency Response, said people must change.
"The world has never seen a serious, grave and complex crisis of this nature where people are dying every day with unsafe burial practices," he said in Freetown, the Sierra Leone capital.
A commentary on a website, Sierra Leone News Hunters, suggested that a memorial site be built to honor the dead who do not receive traditional burial rites, and to provide some comfort to their families.
It said: "The erection of a monument bearing the names of all Ebola victims would not take away the sad memories but it would at least pacify the broken heart somewhat."
AP reporter Clarence Roy-Macaulay in Freetown, Sierra Leone contributed to this report.