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Sparse trees hide the entryway. One descending wooden passageway leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a break area with a laundry appliance and kettle, doctors keep an eye on a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Hospital personnel at an underground hospital observe a screen showing Russian kamikaze and reconnaissance UAVs in the region.

This is the nation's covert underground medical facility. This center began operations in August and is the second of its kind, located 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. It’s the safest method of delivering care to our injured soldiers. And it keeps healthcare workers protected,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a each day. Cases differ widely. Some have catastrophic limb trauma requiring surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which release grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter few bullet injuries. This is an era of drones and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean installation for treating injured soldiers in eastern Ukraine.

During one afternoon recently, three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a minor wound in his leg. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the Russians dropped a another grenade on him.” He added: “Everything in the village is destroyed. There are UAVs everywhere and bodies. Our side's and theirs.”

The soldier said his unit spent 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their location was on foot. Necessary provisions came by quadcopter: rations and drinking water. A week after he was injured, he walked five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been killed. We face ongoing detonations.” A builder working in a neighboring country, he said he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a medical cot, took off a bloody dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to call his sister. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to go back to my unit. Our forces must protect our country,” he affirmed.

Medical staff care for the wounded soldier, who was injured in the back by a piece of artillery shell.

Over the past years, Russia has consistently targeted hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been killed in nearly two thousand attacks. The underground facility is constructed from multiple steel bunkers, with wooden supports, soil and granular material placed above reaching ground level. It can withstand direct hits from large-caliber projectiles and even multiple eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which funded the construction, plans to erect twenty units in all. The head of the nation's security agency and ex- military leader, Rustem Umerov, said they would be “critically important for preserving the survival of our military and supporting troops on the battlefront.” The organization described the initiative as the “largest-scale and challenging” it had undertaken since Russia’s military offensive.

An example of the centre’s surgical rooms.

The surgeon, explained some wounded personnel had to endure delays hours or even days before they could be transported because of the danger of air assaults. “We had two severely injured casualties 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 on 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 concentrate,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The transport was stationed under a bush. The patient and the other military members were taken to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, walked up to the doorway to greet the incoming patients. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”