Toughest Place To Be . . . review: Get away from the frying pan with a week in the fire

It's hard to guess at the precise intention behind Toughest Place To Be . . . (RTÉ One, Monday, 9.35pm), which you can watch as a sobering documentary of international hardships or as a cautionary example of the worse off, designed to make you more content in your daily suffering.

This suite of factual shows plucks hard-working Irish people out from their daily grind at home, where there is every reason to complain, and whisks them away to perform the same duties in conditions that closely resemble a heaving nightmare. Last year it began by taking a Temple Bar street sweeper to an overflowing Manilla. Now it returns, in the first of two parts, to take a Waterford-based A&E nurse, Berna Breen, to Tegucigalpa in Honduras, one of the most violent places on Earth. The grass there is not greener. The earth is completely scorched.

This, inevitably, will be a humbling experience for both Breen and the viewer. But, like the first-world parent who raises the spectre of starving children in Africa to encourage her kids to finish their greens, it’s an example of poverty and desperation too extreme to merely serve to make people feel more thankful for their lot.

We meet Berna, an efficient and caring medical professional, in Waterford University Hospital, where she itemises her daily challenges: "Farm and construction accidents; slips, trips and falls; a lot of sporting injuries, children falling from slides . . . " When we see Berna steadying a Honduran construction worker a few minutes later, who groans without pain relief (there isn't any) while doctors try to reattach his hand, she seems a little unsure of her function. (She doesn't speak Spanish, and the show is shy about featuring intermediaries.)

When she negotiates cramped corridors overflowing with both the perpetrators and victims of the city’s epidemic of gang violence (one person is murdered every hour in Honduras), monitored by soldiers with guns and balaclavas, she bears the look of someone who realises, too late, that she has embarked on a severe kind of travel show, getting away from it all in the frying pan to spend a week in the roaring fire.

If that sounds purgatorial, it's reinforced by attitudes in the Hospital Escuela Universitario. Berna stays with Felipe Calix, a resilient head nurse whose eldest son was murdered for less than $1,000. "You just have to put your faith in God," Calix says at one point, a common refrain of the truly desperate. Conviction in such circumstances is essential, however, whether spiritual or professional, and Calix's has been put to unimaginable tests. "The oath that I took in nursing is to save lives," she says, in a hospital flooded with gang members, "even if he is a criminal."

Berna is an interesting guide, innocent but not naive, efficient and empathetic, and entirely out of her depth. A tough-talking voice-over chews through punishing facts about Honduras, a principal artery of the drug trade, which became a breeding ground for gangs that now operate almost with impunity. Sometimes that voice over seems to be instructing Berna, as when she visits a rehabilitation for gang members to conduct an extraordinarily disturbing interview.

At such moments, director Maurice Sweeney seems to be making a broader documentary by stealth, with Berna as his proxy and several Hondurans at the front line of chaos sharing stories more candidly. Few come more insightful than Marina, a senior nurse, who has also experienced traumatic loss, and never mentions God. "The country is militarised," she says. "This is the sign of a weak state. Security is what we wanted. And what they're offering us is not security. It is control. We don't want guns, we want medicine in the hospital."

In a coda that sighs with relief, Berna returns home. Here, even squeamish viewer find the sight of a farmer’s finger oozing blood oddly comforting, following graphic displays of the consequence of gun, knife and machete attacks. Just that access, to the private pain of regular Hondurans, expertly filmed and edited, leaves a guilty feeling. Berna’s appreciation of the embarrassment of resources an Irish health service has in comparison, is only the start of it. In the overkill of its example, Honduras is not only one of the toughest places to be an A&E nurse, it may be one of the toughest places to be a human being.