The ortho physio team on the Surgery Ship on SBS One.

The ortho physio team on the Surgery Ship on SBS One.

Sometimes it appears that our health system is in crisis, with bed closures and budget crises often the dominant theme. But if you want to see what life is like without the safety net of a First World health system - however flawed some might think it - then you need to watch Surgery Ship (SBS One, 8.30pm).

In this bracing, often heart-rending documentary, a dozen Australian medical personnel are among the 450 volunteers who staff the Africa Mercy, a floating hospital that spends each year docked in the port of a different African nation performing thousands of surgeries free of charge.

Before dawn on the first day of consultations more than 2000 are queued up and you will see shocking images. Benign tumours, for example, aren't so benign if they grow unchecked for a decade or more - some sufferers slowly asphyxiate because their airways become blocked.

Ably narrated by Toni Collette, the program shows both triumphs and tragedies. Yaya, a homeless seven-year-old boy, has his corkscrew legs repaired so he can walk again but the father of two-year-old Amadou has to be told that the staff can't operate on his son because surgery on a malignant tumour is ineffective without the necessary local chemotherapy regimen to follow up the procedure.

''We're not as invincible as we feel in Australia,'' notes Nerida, a plastic surgeon whose skills save lives. She calmly says that two hours into a mammoth surgery on a 13-year-old girl's facial tumour, in which more than a litre of blood has been lost.

There may have been scope to learn more about Nerida and veteran medico Neil and what motivates them but the documentary is concise, affecting and powerful. It might make you look differently at your Medicare card and perhaps visit mercyships.org.au, where donations can be made.

Nothing else on tonight could be as wrenching as Surgery Ship (unless Toadie is leaving Neighbours), so indulge in some smart frivolity. Cougar Town (Seven, 11.30pm) has changed greatly over four seasons and generally for the better. Courteney Cox's divorcee Jules has long stopped chasing younger men and, now remarried, she is at the centre of a blithely dysfunctional gang.

This is a sitcom that celebrates the rules of being a sitcom by sending them up. Watch for Tom, the minor character who's always in the background to supply affirmation to Jules, or Busy Philipps' Laurie, who is one of television's great airheads.

At The Movies (ABC1, 9.25 pm) wraps up for the year tonight, with an hour's worth of Boxing Day and January releases under consideration. Stock up on exasperated retorts and quizzical eyebrows before David Stratton and Margaret Pomeranz disappear into a cinema for the summer.