Last year's Ebola outbreak, which killed over 4,000 people in West Africa, continues to leave its mark even on those who were not infected.
According to the United Nations children’s agency, UNICEF, over 70,000 births between August 2014 and January 2015 were left unregistered in Liberia during the Ebola crisis.
This translates to a 39 percent drop in registrations from pre-Ebola levels, with only 700 births registered between January and May of this year.
The registration of a birth is a crucial step in ensuring that a child’s basic rights are protected.
Without that piece of paper, a child is left vulnerable to anything from being trafficked, illegally adopted, forced into labor, drafted into armed forces, marriage and, in some cases, being tried as an adult.
Deirdre Kiernan, UNICEF’s acting representative and senior emergency coordinator in Liberia, told Al Jazeera America that in addition to a dramatic reduction in services, families were not keen on going anywhere to register the birth of a child.
“People weren't really moving around — they weren't congregating … [registering a birth] was the last thing on people's mind,” said Kiernan.
“People were too preoccupied with other things,” she added.
An unregistered birth means the child does not have a birth certificated and does not officially exist, is not a citizen and will not have access to health services, education and travel documents.
Prior to the Ebola outbreak, Liberia was making gains in the area of birth registrations – the country went from a low of having roughly 4 percent of its births registered (the world's lowest rate) to about 25 percent.
The increase came about as a result of a number of initiatives, such as registering births via mobile phone in remote areas.
There are efforts to rebuild Liberia's battered medical infrastructure, with a new children’s hospital being opened by Doctors Without Borders Monrovia in April, but a lot of ground has been lost.
“Honestly, almost everything shut down, at least for a good amount of time, from August  to January or February,” said Kiernan, adding that in this time, an even larger than usual number of births took place at home, largely because hospitals were “turning away women because they were worried about vaginal fluid and blood” from potentially infected women.
Keirnan said vaccination campaigns at the end of 2014 and start of 2015 met with terrible results, with only between 20 and 30 percent of targeted children being inoculated, but a recent measles campaign brought hope.
“We were worried that people wouldn't vaccinate their children, but we put a lot social mobilization into it and 90.4 percent of the target population was vaccinated — and this was with people carrying their children to a facility, not a door-to-door campaign,” she added. To Kiernan, this signals a willingness for parents to come out again, babies in tow, to seek services.
This is a potentially good sign in country with nearly 3,700 Ebola orphans, 995 of whom lost both parents and caregivers, as the more children are counted, the more services can be provided to them.
According to recent UNICEF data, the births of nearly a third of children under the age of five, worldwide, have not been registered.
That’s 230 million children as of May 2015 who are not formally recognized in their country of birth.