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Scrubby foliage conceal the entryway. A sloping timber passageway leads down to a brightly lit welcome zone. There is a surgery unit, equipped with gurneys, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Medical personnel at an underground medical center observe a screen showing Russian suicide and reconnaissance UAVs in the area.

Welcome to the nation's secret underground medical facility. The facility opened in the eighth month and is the second of its kind, situated in eastern Ukraine close to the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres under the earth. It’s the most secure way of providing help to our wounded military personnel. And it keeps medical personnel safe,” said the facility's lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point handles 30-40 casualties a each day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Others can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which drop explosives with lethal precision. “90% of our cases are from first-person view drones. We see few gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the surgeon explained.

Maj the senior surgeon at the subterranean facility for caring for wounded soldiers in the eastern region.

During one afternoon recently, three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his limb. “War is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the Russians dropped a another grenade on him.” He added: “Everything in the village is demolished. We see drones all around and bodies. Our side's and the enemy's.”

The soldier explained his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize for many months. Sole access to get to their location was on foot. Necessary provisions came by drone: rations and drinking water. Seven days following he was injured, he traveled 5km (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his physical condition. Following care, a medical attendant gave him fresh non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, 28, stated a first-person view drone ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he said. “I think I was fortunate to survive. My cousin has been lost. We face ongoing explosions.” A construction worker working in a neighboring country, Filipchuk said he had come back to Ukraine and enlisted to fight shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff laid him on a medical cot, removed a bloody dressing and cleaned his two-day-old shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. This may require a few months. After that, to return to my military group. Our forces must protect our country,” he affirmed.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has consistently attacked hospitals, health facilities, obstetric units and ambulances. Per human rights groups, 261 health workers have been killed in nearly two thousand assaults. This subterranean hospital is built from four steel bunkers, with timber beams, earth and sand placed above up to the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg explosive devices released by drone.

The Ukrainian industrial group, which funded the construction, plans to build 20 units in total. A senior official of the nation's national security council and former military leader, Rustem Umerov, declared they would be “critically important for preserving the survival of our military and supporting defenders on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented since the enemy's invasion.

An example of the centre’s operating theatres.

The surgeon, explained certain injured soldiers had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had a pair of severely injured casualties who arrived at 3am. I had to perform a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” What is his method with severe surgeries? “I’ve been medicine for 20 years. One must focus,” he said.

Medical assistants transported Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked under a bush. He and the other soldiers were transferred to the city of Dnipro for additional medical care. The underground hospital staff took a break. The facility's orange feline, the mascot, walked up to the doorway to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”