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Sparse trees conceal the entryway. A sloping wooden passageway descends to a brightly lit reception area. There is a surgery unit, equipped with beds, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and hot water heater, physicians monitor a screen. It shows the movements of Russian surveillance UAVs as they zigzag in the air above.

Medical personnel at an subterranean medical center observe a screen showing enemy kamikaze and reconnaissance drones in the region.

This is Ukraine’s covert below-ground medical facility. This center began operations in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. It’s the most secure method of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the facility's lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty patients a each day. Cases differ widely. Some have devastating leg injuries requiring surgical removal, or serious stomach wounds. Some patients can move on their own. The vast majority are the victims of enemy FPV aerial devices, which release explosives with lethal precision. “Ninety per cent of our patients are from FPVs. We see minimal bullet injuries. It’s an age of unmanned aircraft and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded soldiers in eastern Ukraine.

On one afternoon last week, three military members limped into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had torn a small hole in his limb. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He fell down. Subsequently the enemy forces released a second grenade on him.” He added: “Everything in the village is demolished. We see UAVs everywhere and bodies. Ours and theirs.”

The soldier said his squad endured 43 days in a wooded zone near the city, which enemy forces has been trying to seize since last year. Sole access to get to their position was by walking. Necessary provisions came by quadcopter: food and water. Seven days after he was hurt, he traveled 5km (about 3 miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff assessed his physical condition. Following care, a medical attendant gave him new non-military attire: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view drone ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, recounted a drone blast had left him with concussion. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling 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 noted he had returned to Ukraine and volunteered to serve shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff placed him on a bed, took off a bloody dressing and treated his recent injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his sister. “A piece of mortar struck me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To get better. That will take a few months. Subsequently, to return to my military group. Someone must defend our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Over the past years, enemy forces has repeatedly attacked medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and sand laid on top reaching the surface. It can withstand direct hits from 152mm projectiles and even multiple eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which financed the construction, plans to build 20 facilities in total. A senior official of the nation's national security council and former defence minister, 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 “most ambitious and demanding” it had undertaken since the enemy's invasion.

One of the centre’s operating theatres.

The surgeon, said some injured soldiers had to endure delays hours or even multiple days before they could be evacuated because of the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at 3am. I had to carry out a double amputation on a patient. His bleeding control device had been on for so long there was no alternative.” How did he cope with traumatic operations? “My career in medicine for 20 years. You have to focus,” he said.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The transport was stationed beneath a shrub. The patient and the other soldiers were taken to the urban center of a major city for additional medical care. The subterranean hospital staff paused for rest. The facility's ginger cat, the mascot, padded toward the entrance to await the incoming patients. “Our facility operates active around the clock,” Holovashchenko stated. “The work is continuous.”