A stable in Bethlehem would have been a wretched place to give birth, even by the standards of 2,000 years ago. Despite the opulent colours and implied warmth of our contemporary reproductions of the nativity scene, the conditions in which the Gospels claim Mary gave birth to Jesus would have been exposed, unsanitary and deeply uncomfortable.

One might have imagined that centuries of medical and technological progress would have meant that no modern family would have to go through the sort of ordeal that Mary and Joseph endured in Judaea. But as our report today emphasises, children are still being brought into the world in conditions as bad as those that prevailed in corners of the Roman Empire.

Sierra Leone is pretty much the worst place in the world in which one could be born in 2007. This is a nation left broken by a particularly vicious civil war. The conflict ended five years ago, thanks in large part to the intervention of British troops.

But although the fighting has stopped, the dying continues. The national healthcare system has almost collapsed. It is catastrophically under-funded, lacking in qualified staff and desperately short of equipment. There are fewer than 10 surgeons for the whole country. The result is that the west African state languishes at the bottom of the United Nations' human development index. One in every four babies born in the country dies before reaching their fifth birthday. Nor is it merely the young who are vulnerable. One in six mothers dies in childbirth. Female life expectancy is 42. For men it is just 39.

The citizens of Sierra Leone know that life is brutal and short. It is the reason families tend to have six or seven children each (compared with the UK average of 1.7). The pressure on women to give birth is immense. Families must be large enough to gather firewood, collect water, herd goats and tend crops. And so the pitiful cycle of desperate poverty, death in childbirth and infant mortality continues.

It is easy for those of us fortunate enough to have been born in the rich world, where decent healthcare is available, to ignore the plight of such families. After all, they rarely make it on to our television screens. Their plight is a sort of slow-motion, mundane, tragedy. But it does not need to be this way. There is no reason why babies like Salimatou Sankoh, the girl who is pictured on our front page today, need face such wretched survival odds. Most babies in Sierra Leone die from preventable diseases like diarrhoea, malaria or pneumonia. The provision of basic medical technology, access to clean water and decent sanitation could transform their life chances. And such treatments are relatively inexpensive. A mosquito net costs just 5, an anti-meningitis vaccination 30p.

Save the Children, one of the charities supported by The Independent's Christmas Charity Appeal, is working to improve the life of the children of Kroo Bay in Sierra Leone, where Salimatou was born. The charity teaches mothers about antenatal care and breastfeeding. It provides immunisation and hands out mosquito nets. Save the Children performs this life-saving service in numerous locations across the globe, working on behalf of millions of children like Salimatou.

The nativity scene means many things to different people. To believers it is a joyful symbol of mankind's salvation. To atheists it is merely another image of the winter holiday season. But perhaps when we look at those models of a baby lying in a manger we should all start to see something else too: a reproach for the terrible waste of human life that we tolerate in this age of wealth and plenty.