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Scrubby trees conceal the entrance. One sloping wooden passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and ventilators. And cabinets full of healthcare supplies, medications and neat piles of spare clothes. Within a break area with a washing machine and hot water heater, doctors keep an eye on a display. It shows the movements of enemy surveillance UAVs as they weave in the air above.

Medical personnel at an underground hospital observe a monitor displaying Russian suicide and reconnaissance UAVs in the area.

This is the nation's secret underground medical facility. The facility opened in August and is the second such installation, situated in the eastern part of the country not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. It’s the safest way of delivering care to our wounded military personnel. It also ensures healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station treats thirty to forty patients a day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the victims of Russian FPV aerial devices, which release grenades with lethal accuracy. “90% of our patients are from first-person view drones. We see minimal bullet injuries. This is an era of drones and a new type of war,” the surgeon said.

Major the senior surgeon at the subterranean installation for treating wounded soldiers in the eastern region.

During one afternoon recently, a group of three soldiers limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his limb. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces dropped a second explosive on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his unit spent 43 days in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies arrived by drone: food and drinking water. Seven days after he was injured, he traveled 5km (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a medical attendant gave him new civilian clothes: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV drone caused a minor injury in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly became black. I couldn’t feel any feeling or any sound,” he said. “I believe I was lucky to survive. A relative has been killed. There are ongoing explosions.” A construction worker employed in a neighboring country, Filipchuk noted he had returned to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors laid him on a medical cot, removed a bloody bandage and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he used a cellphone to ring his sister. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. Subsequently, to go back to my military group. Someone must protect our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Over the past years, Russia has consistently attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, earth and sand laid on top reaching ground level. It is designed to resist impacts from 152mm artillery shells and even multiple eight-kilogram explosive devices released by aerial means.

A major steel and mining company, which financed the building, plans to erect 20 units in total. A senior official of Ukraine’s security agency and former defence minister, Rustem Umerov, said they would be “vitally important for preserving the lives of our armed forces and supporting troops on the battlefront.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken since Russia’s military offensive.

One of the centre’s operating theatres.

The surgeon, explained some wounded personnel had to endure delays hours or even multiple days before they could be evacuated due to the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for such an extended period there was no alternative.” What is his method with severe surgeries? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was stationed under a shrub. He and the other soldiers were taken to the city of a major city for further treatment. The underground hospital staff took a break. The facility's orange feline, the mascot, padded toward the entrance to greet the next arrivals. “We are active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”