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Scrubby foliage hide the entryway. One sloping wooden passageway descends to a brightly lit reception area. There is a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus cabinets full of medical equipment, drugs and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, physicians monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an subterranean medical center look at a screen showing enemy suicide and surveillance UAVs in the region.

Welcome to Ukraine’s covert below-ground medical facility. The facility opened in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “We are 6 metres under the earth. This is the safest way of providing help to our wounded military personnel. And it keeps healthcare workers safe,” said the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring amputations, or serious stomach wounds. Others can walk. Almost all are the casualties of Russian FPV aerial devices, which drop grenades with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major the senior surgeon at the underground facility for caring for wounded troops in the eastern region.

During one afternoon last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his limb. “War is terrible. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the village is demolished. We see UAVs everywhere and casualties. Ours and theirs.”

The soldier explained his unit endured 43 days in a wooded zone near the city, which enemy forces has been attempting to capture since last year. Sole access to get to their position was on foot. 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 a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, stated a FPV drone ripped a minor injury in his lower limb.

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. It suddenly became black. I lost sensation anything or any sound,” he said. “I believe I was fortunate to survive. A relative has been killed. We face ongoing detonations.” A builder employed in a neighboring country, he said he had returned to Ukraine and enlisted to fight shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as doctors laid him on a bed, took off a stained dressing and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a cellphone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. That will take a few months. After that, to return to my military group. Our forces must protect our country,” he said.

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

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, maternity wards and emergency vehicles. Per international monitors, over two hundred health workers have been fatally attacked in almost two thousand assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, soil and sand placed above reaching ground level. It can withstand impacts from 152mm projectiles and even three 8kg explosive devices dropped by aerial means.

A major steel and mining company, which financed the construction, intends to erect twenty units in total. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, declared they would be “critically essential for preserving the lives of our armed forces and supporting troops on the frontline.” The organization referred to the initiative as the “most ambitious and demanding” it had implemented after Russia’s invasion.

An example of the centre’s operating theatres.

The surgeon, explained certain injured personnel had to wait many hours or even days before they could be evacuated because of the threat of aerial attacks. “Our facility received a pair of critically ill patients who came at the early hours. It was necessary to carry out a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” What is his method with severe operations? “My career in medicine for 20 years. One must focus,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was stationed under a bush. He and the other soldiers were taken to the urban center of a major city for further treatment. The subterranean medical team paused for rest. The hospital’s ginger cat, the mascot, walked toward the entrance to await the next arrivals. “We are open around the clock,” the surgeon said. “It doesn’t stop.”