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Sparse foliage conceal the entryway. A descending wooden passageway descends to a brightly lit welcome zone. Inside lies a operating ward, equipped with beds, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, drugs and neat piles of extra garments. Within a staff room with a laundry appliance and hot water heater, physicians keep an eye on a display. It shows the flight patterns of Russian spy drones as they weave in the air above.

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

This is Ukraine’s covert underground medical facility. This center opened in August and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits six meters under the ground. This is the most secure method of delivering care to our injured military personnel. And it keeps healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

This medical station handles 30-40 casualties a day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or severe stomach wounds. Some patients can walk. Almost all are the victims of enemy FPV aerial devices, which drop grenades with deadly precision. “Ninety per cent of our patients are from first-person view drones. We encounter few bullet injuries. This is an age of drones and a different kind of conflict,” the surgeon said.

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

On one afternoon recently, three soldiers walked with difficulty into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “War is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the Russians dropped a another grenade on him.” He continued: “All structures in the settlement is destroyed. We see UAVs all around and bodies. Our side's and theirs.”

The soldier said his unit endured 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture for many months. Sole access to get to their position was by walking. All supplies came by quadcopter: food and drinking water. Seven days after he was hurt, he traveled five kilometers (roughly three miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with fresh civilian clothes: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, stated a first-person view aerial device caused 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. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel anything or hear anything,” he said. “I think I was fortunate to remain alive. A relative has been killed. There are ongoing explosions.” A builder employed in Lithuania, Filipchuk said he had come back to Ukraine and volunteered to serve shortly before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as medical staff laid him on a bed, took off a bloody bandage and treated his recent injury from fragments. Covered in a foil blanket, he used a mobile phone to call his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my military group. Someone has to protect our country,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the back by a piece of mortar.

Since 2022, enemy forces has repeatedly attacked medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, 261 medical personnel have been killed in almost two thousand attacks. The underground facility is constructed from multiple steel bunkers, with wooden supports, earth and granular material laid on top reaching the surface. It is designed to resist impacts from large-caliber projectiles and even multiple eight-kilogram TNT charges dropped by aerial means.

The Ukrainian industrial group, which funded the building, intends to build twenty facilities in total. The head of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “critically essential for saving the lives of our military and supporting troops on the frontline.” The company described the project as the “most ambitious and challenging” it had implemented since Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said certain wounded personnel had to endure delays hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “We had two severely injured casualties who arrived at 3am. It was necessary to carry out a double amputation on a patient. His tourniquet had been applied for so long there was no other option.” How did he cope with severe operations? “I’ve been medicine for two decades. You have to focus,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was stationed beneath a shrub. He and the other soldiers were taken to the urban center of a major city for additional medical care. The subterranean hospital staff paused for rest. The facility's orange feline, Vasilevs, walked toward the entrance to await the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”