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Scrubby trees conceal the entryway. A descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus shelves full of medical equipment, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, physicians keep an eye on a display. It shows the movements of enemy surveillance UAVs as they zigzag in the air above.

Medical staff at an subterranean medical center look at a screen displaying enemy suicide and reconnaissance UAVs in the area.

Welcome to Ukraine’s secret below-ground medical facility. This center opened in August and is the second of its kind, situated in the eastern part of the country close to the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres below the ground. It’s the safest way of delivering care to our injured military personnel. And it keeps healthcare workers safe,” stated the facility's surgeon, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma necessitating amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which release explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We encounter minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the doctor said.

Major the senior surgeon at the underground installation for treating wounded soldiers in eastern Ukraine.

On one afternoon last week, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his limb. “War is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “Everything in the village is demolished. There are UAVs everywhere and bodies. Ours and theirs.”

The soldier said his unit spent 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. Necessary provisions came by drone: rations and water. Seven days after he was hurt, he walked five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his physical condition. Following care, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

The soldier, 28, stated a FPV drone ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I think I was fortunate to survive. A relative has been killed. We face continuous explosions.” A builder working in Lithuania, Filipchuk said he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff placed him on a medical cot, took off a stained bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of mortar hit me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. Subsequently, to return to my military group. Our forces has to defend our nation,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of mortar.

Over the past years, enemy forces has consistently targeted hospitals, clinics, maternity wards and ambulances. According to human rights groups, 261 medical personnel have been killed in nearly two thousand assaults. The underground facility is built from four steel bunkers, with wooden supports, soil and granular material placed above up to the surface. It is designed to resist impacts from 152mm projectiles and even multiple 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the construction, intends to erect twenty units in all. A senior official of the nation's security agency and former defence minister, the official, declared they would be “vitally essential for saving the lives of our armed forces and assisting 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 operating theatres.

The surgeon, said certain injured soldiers had to wait many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had two severely injured patients who arrived at the early hours. It was necessary to perform a double amputation on a patient. The soldier's tourniquet had been on for so long there was no alternative.” What is his method with traumatic operations? “My career in healthcare for two decades. You have to focus,” he remarked.

Orderlies transported Mykolaichuk through the tunnel and into an emergency vehicle. The transport was stationed under a shrub. He and the other military members were taken to the urban center of Dnipro for further treatment. The underground medical team took a break. The hospital’s ginger cat, the mascot, padded toward the entrance to await the incoming patients. “We are open around the clock,” Holovashchenko said. “The work is continuous.”