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Sparse trees conceal the entrance. A sloping wooden tunnel descends to a well-illuminated welcome zone. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And shelves full of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Medical staff at an underground hospital look at a screen showing enemy kamikaze and reconnaissance UAVs in the area.

This is the nation's covert below-ground medical facility. This center opened in August and is the second such installation, located in the eastern part of the country not far from the frontline and the city of a key location in Donetsk oblast. “We are six meters below the earth. It’s the most secure way of providing help to our injured soldiers. And it keeps healthcare workers protected,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Some patients can walk. The vast majority are the victims of Russian FPV drones, which drop grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We encounter few bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the subterranean installation for treating injured troops in the eastern region.

On one day last week, three military members limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “War is horrific. The guy next to me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is demolished. There are UAVs everywhere and bodies. Our side's and theirs.”

The soldier explained his unit spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their position was by walking. All supplies came by quadcopter: rations and drinking water. Seven days after he was hurt, he traveled 5km (about 3 miles), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse provided him with new civilian clothes: a T-shirt and a set of pale denim trousers.

The soldier, twenty-eight, stated a FPV aerial device caused a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I believe I was fortunate to remain alive. A relative has been killed. We face ongoing explosions.” A construction worker working in a neighboring country, he said he had come back to Ukraine and enlisted to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff placed him on a medical cot, removed a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his sister. “A fragment of artillery struck me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Someone has to protect our country,” he affirmed.

Doctors treat the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. Per human rights groups, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. This subterranean hospital is built from multiple steel bunkers, with timber beams, earth and sand laid on top up to the surface. It can withstand impacts from large-caliber projectiles and even multiple eight-kilogram explosive devices released by drone.

A major steel and mining company, which financed the construction, intends to erect twenty facilities in total. A senior official of Ukraine’s national security council and former defence minister, the official, declared they would be “critically essential for saving the lives of our armed forces and assisting defenders on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken since the enemy's military offensive.

One of the facility's operating theatres.

Holovashchenko, said some wounded personnel had to endure delays many hours or even multiple days before they could be transported due to the danger of air assaults. “We had two critically ill casualties who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period 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 Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked under a shrub. He and the two other soldiers were taken to the urban center of Dnipro for additional medical care. The subterranean medical team took a break. The facility's orange feline, Vasilevs, walked up to the doorway to await the incoming patients. “We are open 24 hours a day,” the surgeon stated. “The work is continuous.”