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Scrubby trees hide the entryway. A descending wooden tunnel leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets full of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a washing machine and kettle, doctors keep an eye on a display. It shows the movements of Russian spy drones as they zigzag in the sky above.

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

Welcome to the nation's secret below-ground medical facility. This center opened in August and is the second of its kind, situated in the eastern part of the country not far from the combat zone and the urban area of a key location in Donetsk oblast. “We are six meters under the earth. This is the most secure method of delivering care to our injured soldiers. It also ensures healthcare workers safe,” said the facility's surgeon, Maj the chief surgeon.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our patients are from FPVs. We see few bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating injured troops in eastern Ukraine.

During one afternoon recently, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a small hole in his limb. “War is horrific. My comrade next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the enemy forces released a second explosive on him.” He added: “Everything in the settlement is destroyed. We see drones all around and casualties. Our side's and the enemy's.”

The soldier said his unit endured over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. Necessary provisions arrived by quadcopter: food and water. Seven days after he was hurt, he walked 5km (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant provided him with new non-military attire: a shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “I was in a dugout. It suddenly became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been killed. We face ongoing detonations.” A construction worker working in Lithuania, he said he had come back to Ukraine and enlisted to fight days before the Russian leader's large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as doctors placed him on a medical cot, took off a stained dressing and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A fragment of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to return to my unit. Our forces must protect our country,” he said.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, enemy forces has repeatedly targeted medical centers, clinics, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, soil and sand laid on top up to the surface. It is designed to resist direct hits from large-caliber artillery shells and even three 8kg explosive devices released by drone.

The Ukrainian industrial group, which financed the construction, plans to erect twenty units in all. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, said they would be “critically essential for saving the lives of our armed forces and assisting troops on the battlefront.” The organization referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the centre’s operating theatres.

Holovashchenko, said some wounded soldiers had to endure delays many hours or even days before they could be transported due to the threat of aerial attacks. “Our facility received two severely injured patients who arrived at the early hours. I had to perform 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 operations? “My career in medicine for two decades. You have to concentrate,” he remarked.

Orderlies transported the soldier through the passage and into an emergency vehicle. The transport was parked under a shrub. The patient and the other military members were taken to the urban center of Dnipro for additional medical care. The subterranean medical team took a break. The facility's ginger cat, Vasilevs, padded toward the doorway to await the next arrivals. “Our facility operates active 24 hours a day,” the surgeon stated. “The work is continuous.”