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Scrubby trees hide the entrance. A sloping wooden tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets full of medical equipment, medications and neat piles of spare clothes. Within a break area with a washing machine and kettle, doctors keep an eye on a screen. The screen reveals the movements of enemy spy drones as they weave in the air above.

Hospital personnel at an underground medical center observe a monitor displaying enemy kamikaze and reconnaissance drones in the region.

This is the nation's covert below-ground medical facility. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the earth. This is the most secure method of providing help to our injured military personnel. It also ensures medical personnel protected,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station handles 30-40 patients a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring amputations, or severe abdominal injuries. Others can walk. The vast majority are the victims of Russian first-person view (FPV) drones, which release explosives with lethal accuracy. “90% of our cases are from FPVs. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the subterranean installation for treating wounded troops in eastern Ukraine.

On one afternoon last week, a group of three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a small hole in his limb. “Conflict is horrific. The guy beside me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the Russians dropped a another explosive on him.” He added: “Everything in the village is demolished. There are drones all around and bodies. Ours and theirs.”

Dvorskyi said his unit endured 43 days in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture for many months. The only way to reach their position was on foot. Necessary provisions came by drone: rations and water. A week following he was injured, he traveled five kilometers (roughly three miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, stated a first-person view aerial device caused a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he said. “I think I was fortunate to remain alive. A relative has been killed. We face continuous explosions.” A construction worker working in Lithuania, Filipchuk said he had returned to his homeland and enlisted to fight shortly before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the back. He groaned as doctors placed him on a bed, took off a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to call his family member. “A fragment of mortar struck me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Our forces has to defend our nation,” he said.

Medical staff treat the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Since 2022, Russia has consistently targeted medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in almost two thousand assaults. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and granular material laid on top up to ground level. It can withstand impacts from 152mm projectiles and even three eight-kilogram TNT charges released by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 facilities in all. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “vitally essential for saving the survival of our military and supporting defenders on the battlefront.” The organization described the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

One of the facility's surgical rooms.

The surgeon, explained some wounded soldiers had to wait many hours or even multiple days before they could be evacuated because of the danger of aerial attacks. “Our facility received a pair of critically ill casualties who came at 3am. I had to perform a double amputation on a patient. His bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “My career in healthcare for 20 years. One must concentrate,” he said.

Medical assistants wheeled the soldier up the passage and into an ambulance. The vehicle was stationed beneath a bush. The patient and the two other soldiers were transferred to the city of a major city for further treatment. The underground hospital staff took a break. The facility's ginger cat, Vasilevs, padded up to the entrance to greet the incoming patients. “We are active 24 hours a day,” the surgeon said. “The work is continuous.”