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Scrubby foliage conceal the entrance. One sloping timber tunnel descends to a well-illuminated reception area. There is a operating ward, equipped with beds, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, medications and organized stacks of extra garments. Within a break area with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

Hospital personnel at an subterranean hospital look at a screen displaying Russian kamikaze and reconnaissance UAVs in the area.

This is the nation's secret underground medical facility. This center began operations in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the safest method of providing help to our wounded soldiers. And it keeps medical personnel safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

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

Maj the senior surgeon at the subterranean installation for treating wounded troops in the eastern region.

During one afternoon recently, three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his leg. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces dropped a second explosive on him.” He continued: “Everything in the village is destroyed. There are UAVs all around and bodies. Ours and the enemy's.”

The soldier explained his unit spent 43 days in a forest area close to the city, which Russia has been attempting to capture since last year. Sole access to get to their location was on foot. All supplies came by drone: rations and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse gave him new civilian clothes: a T-shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a first-person view drone caused a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been killed. There are continuous detonations.” A builder working in Lithuania, he said he had returned to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, removed a stained bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to ring his family member. “A piece of mortar struck me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a few months. Subsequently, to return to my military group. Our forces has to defend our nation,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently targeted hospitals, clinics, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from four steel bunkers, with timber beams, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg TNT charges released by drone.

A major steel and mining company, which financed the construction, plans to build 20 facilities in total. A senior official of Ukraine’s national security council and former defence minister, the official, declared they would be “vitally important for saving the survival of our military and supporting defenders on the frontline.” The organization described the initiative as the “most ambitious and demanding” it had implemented after the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said certain injured soldiers had to wait hours or even days before they could be transported due to the threat of aerial attacks. “Our facility received a pair of severely injured casualties who arrived at 3am. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been applied for so long there was no other option.” What is his method with traumatic surgeries? “I’ve been medicine for 20 years. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other soldiers were taken to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The facility's orange feline, the mascot, padded toward the doorway to await the incoming patients. “We are active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”