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Scrubby trees hide the entrance. One sloping wooden passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. And shelves stocked of medical equipment, medications and organized stacks of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians monitor a display. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an underground hospital look at a monitor showing enemy kamikaze and reconnaissance UAVs in the region.

This is the nation's secret underground medical facility. This center opened in August and is the second of its kind, located in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “We are 6 metres below the earth. This is the most secure method of delivering care to our injured soldiers. And it keeps medical personnel safe,” said the facility's lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or severe stomach wounds. Some patients can move on their own. The vast majority are the victims of enemy FPV drones, which drop grenades with lethal precision. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of war,” the surgeon explained.

Major the senior surgeon at the subterranean facility for caring for injured soldiers in eastern Ukraine.

On one day last week, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone blast had torn a small hole in his leg. “War is terrible. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Then the enemy forces released a second explosive on him.” He continued: “Everything in the village is destroyed. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit endured 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 on foot. All supplies came by quadcopter: rations and water. A week following he was hurt, he traveled five kilometers (about 3 miles), taking three hours, to a point where an military transport was able to pick him up. Upon arrival, a medic assessed his physical condition. After treatment, a nurse gave him new non-military attire: a shirt and a set of pale denim trousers.

The soldier, twenty-eight, stated a FPV aerial device caused a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he said. “I think I was lucky to remain alive. A relative has been killed. We face continuous explosions.” A builder employed in Lithuania, he said he had returned to his homeland and volunteered to fight shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a bed, removed a bloody bandage and treated his recent shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his family member. “A fragment of artillery hit me. It was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a few months. Subsequently, to return to my unit. Our forces must protect our country,” he said.

Doctors treat the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Over the past years, enemy forces has consistently attacked medical centers, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been killed in nearly 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, earth and granular material laid on top reaching the surface. It can withstand impacts from large-caliber projectiles and even multiple 8kg explosive devices released by drone.

The Ukrainian industrial group, which financed the construction, plans to build twenty facilities in total. A senior official of the nation's national security council and ex- military leader, Rustem Umerov, declared they would be “critically essential for preserving the survival of our military and assisting defenders on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had implemented since Russia’s military offensive.

An example of the centre’s operating theatres.

The surgeon, said some injured personnel had to wait hours or even days before they could be transported because of the threat of aerial attacks. “We had a pair of severely injured patients who came at 3am. I had to carry out a double amputation on one of them. His tourniquet had been applied for such an extended period there was no alternative.” How did he cope with severe surgeries? “My career in healthcare for two decades. You have to focus,” he remarked.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked beneath a shrub. The patient and the other soldiers were transferred to the city of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, Vasilevs, walked up to the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”