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Scrubby trees hide the entrance. A descending timber tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, doctors keep an eye on a screen. It shows the movements of enemy surveillance UAVs as they weave in the sky above.

Medical staff at an subterranean hospital observe a monitor displaying enemy kamikaze and surveillance drones in the region.

This is Ukraine’s secret underground medical facility. The facility opened in the eighth month and is the second of its kind, located in the eastern part of the country not far from the frontline and the city of a key location in Donetsk oblast. “Our facility sits six meters under the ground. It’s the safest method of providing help to our injured soldiers. And it keeps healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian first-person view (FPV) drones, which release grenades with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal gunshot wounds. This is an age of drones and a different kind of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for treating injured troops in eastern Ukraine.

During one day recently, three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his limb. “War is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians released a second explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs everywhere and casualties. Ours and theirs.”

The soldier explained his squad endured 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to reach their location was by walking. All supplies arrived by quadcopter: food and drinking water. A week following he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with new non-military attire: a T-shirt and a set of pale jeans.

The soldier, 28, said a FPV aerial device ripped a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had left him with concussion. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or any sound,” he explained. “I think I was fortunate to survive. A relative has been killed. There are continuous explosions.” A construction worker working in a neighboring country, he said he had returned to his homeland and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a bed, took off a bloody bandage and cleaned his two-day-old injury from fragments. Covered in a foil blanket, he borrowed a mobile phone to ring his sister. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. This may require a few months. After that, to return to my military group. Someone has to protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a piece of mortar.

Over the past years, Russia has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. According to human rights groups, over two hundred health workers have been killed in nearly two thousand assaults. The underground facility is built from four reinforced shelters, with timber beams, earth and sand placed above reaching ground level. It is designed to resist impacts from large-caliber projectiles and even three 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which financed the building, plans to build 20 units in all. The head of Ukraine’s national security council and ex- military leader, the official, declared they would be “vitally essential for preserving the survival of our military and assisting defenders on the battlefront.” The organization described the initiative as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

One of the centre’s operating theatres.

Holovashchenko, said certain injured personnel had to wait many hours or even days before they could be evacuated because of the danger of air assaults. “We had a pair of severely injured casualties who arrived at the early hours. I had to perform a removal of both limbs on one of them. His tourniquet had been applied for so long there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for two decades. You have to concentrate,” he remarked.

Medical assistants transported the soldier up the passage and into an emergency vehicle. The transport was parked beneath a shrub. The patient and the other military members were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, the mascot, padded up to the doorway to greet the incoming patients. “Our facility operates active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”