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Scrubby foliage hide the entryway. One descending wooden tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, drugs and neat piles of extra garments. In a break area with a laundry appliance and hot water heater, doctors monitor a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground medical center look at a monitor displaying enemy kamikaze and reconnaissance UAVs in the region.

This is the nation's covert below-ground medical facility. The facility opened in August and is the second such installation, located in eastern Ukraine close to the frontline and the urban area of a key location in Donetsk oblast. “We are six meters under the ground. It’s the safest way of providing help to our injured soldiers. It also ensures healthcare workers safe,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles 30-40 casualties a day. Their conditions vary. Some have devastating limb trauma requiring amputations, or serious stomach wounds. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) drones, which release grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We see few gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for wounded soldiers in eastern Ukraine.

On one day recently, three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a small hole in his limb. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He continued: “All structures in the settlement is demolished. There are drones everywhere and bodies. Ours and the enemy's.”

The soldier explained his unit spent 43 days in a wooded zone near the city, which Russia has been attempting to capture for many months. The only way to reach their location was by walking. All supplies came by drone: food and drinking water. Seven days after he was hurt, he walked five kilometers (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his physical condition. After treatment, a nurse provided him with new non-military attire: a shirt and a pair of pale denim trousers.

The soldier, 28, stated a FPV aerial device ripped a minor injury in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted 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 believe I was lucky to remain alive. A relative has been lost. There are continuous detonations.” A builder employed in a neighboring country, he said he had returned to Ukraine and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors laid him on a medical cot, took off a stained dressing and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A piece of mortar hit me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. Subsequently, to go back to my military group. Our forces must defend our country,” he said.

Medical staff care for the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Over the past years, Russia has repeatedly targeted hospitals, clinics, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple steel bunkers, with wooden supports, soil and granular material placed above up to ground level. It is designed to resist impacts from 152mm projectiles and even three eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which financed the building, plans to erect 20 units in total. A senior official of the nation's security agency and ex- military leader, Rustem Umerov, declared they would be “critically essential for preserving the lives of our armed forces and supporting troops on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained some injured soldiers had to wait hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at 3am. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with severe surgeries? “My career in medicine for 20 years. You have to concentrate,” he said.

Orderlies wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the two other soldiers were transferred to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The facility's ginger cat, the mascot, walked toward the entrance to greet the incoming patients. “We are active around the clock,” Holovashchenko said. “The work is continuous.”