MONROVIA, Liberia (AP) — Liberians gathered this week to mark a decade since the country was hit by a devastating Ebola outbreak that killed more than 10,000 people in West Africa, adding to the region’s economic and political troubles.

The second Wednesday of March in Liberia, National Decoration Day, is always one of remembrance and people gathered this year at a memorial site where many victims of the virus were buried outside the capital, Monrovia, to pay their respects to family and friends. It was a grim milestone for those who lost loved ones to the virus, even though cultural stigma leads many to insist they died of other causes.

The Ebola outbreak killed some 11,000 people mainly in Liberia, Sierra Leone and Guinea, according to the United Nations. Liberia was declared free of the virus in 2016, after almost 5,000 deaths.

Many Liberians who lost loved ones during the outbreak deny the virus was to blame. Stigma and fear of the disease remain widespread in the population that survived.

Yasa Johnson told The Associated Press she has looked after her younger siblings since Ebola killed their mother.

“I have come to honor my mother,” she said at the Disco Hill Safe Burial Site in Margibi County, where many victims were buried on the outskirts of the capital.

Some 4,500 people are buried or cremated at the site, the National Public Health Institute of Liberia said. Relatives stood in groups carrying flowers and singing religious songs.

Elizabeth Brown and her husband, who operate an orphanage for children who lost their parents to the virus, also came to pay their respects.

“It saddens me, because their lives were cut off too soon,” she said. “We just want to help them.”

Since the outbreak, Liberia has been marked by ongoing economic struggles. Its newly elected president, Joseph Boakai, 79, came to office in January on a pledge to fix the economy, improve security and fight corruption.