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Scrubby foliage hide the entrance. One descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. Plus shelves stocked of healthcare supplies, medications and organized stacks of spare clothes. In a break area with a washing machine and hot water heater, physicians keep an eye on a screen. The screen reveals the movements of Russian spy drones as they weave in the sky above.

Hospital personnel at an subterranean medical center look at a monitor showing enemy suicide and reconnaissance UAVs in the region.

This is the nation's secret below-ground medical facility. The facility began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the safest method of delivering care to our wounded military personnel. It also ensures healthcare workers protected,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma necessitating amputations, or serious abdominal injuries. Some patients can walk. Almost all are the victims of Russian FPV drones, which drop explosives with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a different kind of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean installation for treating wounded soldiers in the eastern region.

On one afternoon last week, three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, Vasyl, was killed,” he said. “He collapsed. Then the enemy forces dropped a second explosive on him.” He continued: “Everything in the settlement is demolished. There are drones all around and bodies. Ours and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone near Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their location was by walking. All supplies came by quadcopter: food and drinking water. A week following he was injured, he walked five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a nurse provided him with new civilian clothes: a shirt and a set of light-colored jeans.

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

A different casualty, 38-year-old a serviceman, said a drone blast had resulted in a head injury. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to survive. My cousin has been lost. There are continuous explosions.” A construction worker working in Lithuania, he noted he had come back to Ukraine and enlisted to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a stained dressing and treated his two-day-old injury from fragments. Covered in a foil blanket, he used a mobile phone to call his family member. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. This may require a few months. After that, to return to my unit. Our forces has to defend our nation,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in nearly 2,000 attacks. The underground facility is built from four steel bunkers, with wooden supports, soil and granular material laid on top reaching ground level. It is designed to resist impacts from 152mm artillery shells and even multiple eight-kilogram TNT charges dropped by aerial means.

A major steel and mining company, which financed the building, intends to build 20 facilities in all. The head of the nation's security agency and former military leader, Rustem Umerov, said they would be “critically important for preserving the survival of our military and supporting defenders on the battlefront.” The company described the project as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

One of the centre’s operating theatres.

The surgeon, explained some wounded soldiers had to wait hours or even days before they could be evacuated due to the danger of air assaults. “We had a pair of critically ill patients who came at 3am. I had to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with severe operations? “I’ve been medicine for 20 years. You have to focus,” he remarked.

Orderlies wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked under a shrub. The patient and the other soldiers were taken to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The facility's ginger cat, Vasilevs, walked up to the entrance to greet the incoming patients. “We are open around the clock,” the surgeon stated. “It doesn’t stop.”