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Scrubby foliage hide the entrance. One sloping timber passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, equipped with gurneys, heart rate sensors and ventilators. And cabinets stocked of medical equipment, medications and neat piles of spare clothes. Within a break area with a washing machine and kettle, doctors keep an eye on a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

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

This is Ukraine’s covert underground medical facility. This center began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. This is the most secure way of providing help to our wounded soldiers. And it keeps medical personnel protected,” stated the facility's lead doctor, Major the chief surgeon.

The stabilisation point handles 30-40 casualties a day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring surgical removal, or serious stomach wounds. Others can move on their own. Almost all are the casualties of Russian FPV aerial devices, which release grenades with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded troops in the eastern region.

During one day last week, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, said an FPV explosion had ripped a small hole in his limb. “War is horrific. My comrade beside me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians dropped a second explosive on him.” He continued: “All structures in the settlement is demolished. There are UAVs all around and casualties. Ours and the enemy's.”

The soldier explained his squad spent 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to reach their position was by walking. Necessary provisions came by drone: rations and drinking water. A week after he was hurt, he walked 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant gave him new non-military attire: a shirt and a set of pale jeans.

The soldier, twenty-eight, stated a FPV drone caused a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. It suddenly became black. I lost sensation any feeling or hear anything,” he explained. “I think I was fortunate to remain alive. A relative has been killed. There are ongoing explosions.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, took off a stained dressing and cleaned his two-day-old injury from fragments. Covered in a foil blanket, he borrowed a cellphone to ring his sister. “A piece of artillery hit me. It was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. This may require a several months. After that, to go back to my military group. Our forces must protect our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a piece of mortar.

Over the past years, Russia has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in almost two thousand assaults. This subterranean hospital is built from four steel bunkers, with timber beams, soil and granular material laid on top reaching ground level. It is designed to resist direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges released by drone.

A major steel and mining company, which financed the building, plans to build twenty units in all. A senior official of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “critically essential for preserving the lives of our armed forces and supporting troops on the battlefront.” The company referred to the initiative as the “largest-scale and demanding” it had undertaken after Russia’s invasion.

An example of the facility's surgical rooms.

Holovashchenko, explained some wounded soldiers had to wait hours or even multiple days before they could be transported due to the threat of air assaults. “Our facility received a pair of severely injured casualties who arrived at the early hours. It was necessary to carry out a double amputation on one of them. His tourniquet had been applied for so long there was no alternative.” What is his method with severe operations? “My career in healthcare for two decades. You have to concentrate,” he said.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other soldiers were taken to the city of Dnipro for additional medical care. The subterranean hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded toward the entrance to greet the next arrivals. “Our facility operates active 24 hours a day,” the surgeon said. “It doesn’t stop.”