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Conspiracy Theory

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Some Ebola-Stricken African Families Pay Bribes for Fake Death Records

An Ebola burial team carried the body of a woman from a home in New Kru Town, a suburb of Liberia’s capital Monrovia, on Friday Getty Images

MONROVIA, Liberia—Some of the teams sent to retrieve bodies of suspected Ebola victims here are collecting cash instead, allegedly accepting bribes to issue death certificates to families saying their loved ones died of other causes and leaving the body, locals and health workers say.

It is a troubling development for an outbreak in which dead bodies are a major source of contagion and one that suggests local corruption could help undermine the international effort to contain the virus.

Liberian funerals typically include washing the body and keeping it for a wake that can last days as relatives and friends come by and kiss the corpse before it is buried, often in a family cemetery nearby. In addition, Ebola infection carries a stigma in the country and people sometimes don’t want to admit a family member died of the disease.

Andrew Medina-Marino, an epidemiologist at South Africa’s University of Pretoria who was recently in Liberia helping with the Ebola response, said he had received reports of people paying bribes to Ebola-response teams so they would look the other way while they washed and buried the bodies. Those bribes contributed to the challenges of containing the epidemic that has killed more than 4,000 people.

“Low-level corruption has a high-level impact,” Mr. Medina-Marino said.

In Caldwell township outside the capital, Commissioner Hawa Johnson said she had stopped issuing burial permits to anyone who didn’t have a death certificate from a hospital confirming a non-Ebola death after one of her workers discovered that body-retrieval teams had offered to sell fake death certificates in the community. Similarly, funeral-home directors have said they are double-checking death certificates with the doctor that signed them. But many families just use private plots.

Community-outreach worker Vincent Chounse said he has seen the negotiation happen four times in front of him in Bardnersville—another township on the outskirts of Monrovia.

“The family says the person is not an Ebola patient and they pull them away from the other people. Then they say, ‘We can give you a certificate from the Ministry of Health that it wasn’t Ebola,’ ” he says. “Sometimes it is $40. Sometimes it is $50.…Then they offer bags to them and [the family] carry on their own thing.”

Mr. Chounse, 36 years old, is a local volunteer at the front line of the effort to find a way to handle the bodies of Ebola victims that grieving families will accept and that doesn’t risk spreading the disease further. The amount of the Ebola virus in the bloodstream increases as the disease progresses, meaning bodies of the recently deceased are particularly contagious.

There is a hotline for Liberians to call when someone has died. The Red Cross, Doctors Without Borders and the Liberian government have people manning the teams that go into communities in Montserrado County—which includes the capital city and surrounding townships—to retrieve bodies. Other counties may turn to additional entities to retrieve bodies. Mr. Chounse said he was unsure of the organization employing the people he said solicited bribes.

The government has decreed that anyone who dies of Ebola should be cremated, both to prevent the spread of disease and because many communities have been refusing to bury the bodies of Ebola victims even when the burial is done according to a strict procedure to prevent transmission.

The crematorium in Monrovia is incinerating about 60 bodies a day, said Agnes “Cokie” Van der Velde, who manages body-collection teams for Doctors Without Borders. She said she wasn’t aware of faked death certificates. She said awareness of the danger of dead bodies has been increasing, but that many families are still reticent to report possible Ebola deaths because they want to have a traditional burial.

“We are not receiving the amount of community calls that we should be,” given the number of people showing up in treatment centers with Ebola, she said. When people do call, it is usually a neighbor or a community-outreach worker like Mr. Chounse, not the family members themselves.

“We try to be very respectful, but in the end what we’re doing is taking their loved one, zipping them in a bag and taking them away,” Ms. Van der Velde said.

Government Information Minister Lewis Brown said his office had received reports of health workers issuing fake death certificates to families so they could avoid the stigma of having to admit a family member died of Ebola, but that they didn’t know of anyone selling these certificates, or families using them to keep a body that would otherwise have been taken away. He said body-retrieval teams don’t include anyone authorized to rule on how someone died.

“I know of no burial team with a capacity to go and issue certificates,” he said, adding that families of people confirmed to have died of Ebola, and who have a gravesite that will take them, can put in a request for a burial conducted by an authorized team that can do it safely. He explained that cremation was instituted because so many communities were rejecting the bodies of Ebola victims.

Contacted about the corruption allegations, the Liberian Red Cross said its agents have met resistance, but that none of its 16 teams have taken bribes or left bodies with families.

“There has been no case where we went into the community and then a family member prevented us absolutely and we didn’t take the body,” said Oniel Bestman, a spokesman for the Liberian Red Cross.

The problem doesn’t appear to be limited to one region. In Grand Gedeh County, next to Montserrado, 17-year-old Robert Johnson said he saw the man who lives next door to him fall ill with the classic symptoms—vomiting and repeated bathroom trips. When the man died, a body-retrieval team contracted from a local funeral home came to collect the body. When the family protested, Mr. Johnson said, he watched them offer a document certifying that the body was Ebola-free for $150. The man’s father paid up, he said.

Mr. Johnson said he is confused about why the government tells residents to call the body-retrieval teams and then the teams don’t insist on taking the corpses. “They told us not to bury the bodies. They told us to call. But now I am not sure if they are the ones trying to eradicate this virus or to make it grow.”

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