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Sparse trees conceal the entryway. A descending wooden tunnel leads down to a well-illuminated welcome zone. There is a operating ward, outfitted with gurneys, cardiac monitors and ventilators. Plus cabinets full of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a laundry appliance and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Medical personnel at an underground medical center look at a screen showing enemy suicide and reconnaissance drones in the area.

This is Ukraine’s secret below-ground medical facility. The facility began operations in the eighth month and is the second of its kind, situated in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the ground. It’s the most secure way of providing help to our injured soldiers. And it keeps healthcare workers safe,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Their conditions vary. Some have catastrophic limb trauma necessitating amputations, or severe stomach wounds. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. This is an age of drones and a new type of war,” the doctor said.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded troops in the eastern region.

On one afternoon last week, three military members limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his leg. “Conflict is horrific. My comrade beside me, a fellow soldier, was killed,” he stated. “He fell down. Subsequently the enemy forces released a second grenade on him.” He continued: “All structures in the village is demolished. There are drones all around and casualties. Ours and the enemy's.”

The soldier said his squad spent over a month in a forest area close to the city, which Russia has been attempting to capture for many months. Sole access to get to their location was by walking. Necessary provisions came by quadcopter: rations and drinking water. A week following he was injured, he traveled 5km (roughly three miles), taking three hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a medical attendant gave him new non-military attire: a shirt and a pair of pale jeans.

Artem Dvorskiy, 28, stated a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been lost. We face ongoing detonations.” A builder employed in a neighboring country, Filipchuk noted he had returned to his homeland and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the back. He groaned as medical staff laid him on a medical cot, took off a stained bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to call his family member. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to go back to my military group. Someone must defend our nation,” he affirmed.

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

Over the past years, enemy forces has repeatedly attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 health workers have been killed in almost two thousand attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and granular material laid on top reaching ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg explosive devices dropped by drone.

A major industrial group, which financed the building, intends to erect twenty units in total. A senior official of Ukraine’s national security council and ex- military leader, the official, said they would be “vitally important for preserving the lives of our armed forces and supporting defenders on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had implemented since Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, said some injured personnel had to wait hours or even multiple days before they could be transported due to the threat of aerial attacks. “Our facility received a pair of severely injured patients who arrived at 3am. It was necessary to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. You have to focus,” he said.

Orderlies wheeled Mykolaichuk up the passage and into an emergency vehicle. The transport was parked beneath a shrub. The patient and the two other soldiers were transferred to the urban center of a major city for further treatment. The underground hospital staff took a break. The facility's orange feline, Vasilevs, padded up to the entrance to greet the incoming patients. “Our facility operates active 24 hours a day,” the surgeon said. “It doesn’t stop.”