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Sparse trees hide the entrance. One descending timber passageway leads down to a well-illuminated welcome zone. There is a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus shelves stocked of healthcare supplies, medications and organized stacks of spare clothes. In a staff room with a washing machine and hot water heater, physicians monitor a screen. It shows the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Medical staff at an subterranean medical center look at a monitor displaying Russian suicide and surveillance UAVs in the area.

Welcome to the nation's secret underground medical facility. This center opened in the eighth month and is the second of its kind, located in the eastern part of the country close to the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. This is the most secure way of providing help to our injured military personnel. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point handles 30-40 patients a each day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or serious abdominal injuries. Others can move on their own. The vast majority are the victims of enemy FPV aerial devices, which drop grenades with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We see few bullet injuries. It’s an era of unmanned aircraft and a new type of conflict,” the doctor said.

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

During one afternoon recently, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his limb. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He continued: “Everything in the village is demolished. We see UAVs all around and bodies. Our side's and theirs.”

The soldier explained his unit spent over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their position was by walking. All supplies came by quadcopter: rations and water. Seven days after he was hurt, he traveled five kilometers (roughly three miles), taking three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff checked his physical condition. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “My position was in a dugout. It suddenly became black. I couldn’t feel anything or any sound,” he explained. “I think I was fortunate to survive. A relative has been lost. There are ongoing detonations.” A builder employed in a neighboring country, he noted he had returned to Ukraine and volunteered to serve shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff laid him on a bed, took off a bloody bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he used a mobile phone to call his sister. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my unit. Someone must defend our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly targeted hospitals, health facilities, obstetric units and emergency vehicles. According to human rights groups, over two hundred medical personnel have been fatally attacked in almost two thousand assaults. The underground facility is built from four reinforced shelters, with wooden supports, soil and granular material laid on top reaching ground level. It can withstand direct hits from 152mm projectiles and even multiple 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to build twenty units in total. A senior official of Ukraine’s security agency and ex- defence minister, Rustem Umerov, said they would be “critically important for preserving the survival of our military and assisting troops on the battlefront.” The company described the initiative as the “most ambitious and demanding” it had implemented after Russia’s invasion.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain injured personnel had to wait many hours or even days before they could be transported because of the danger of aerial attacks. “We had a pair of critically ill casualties who arrived at 3am. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no other option.” What is his method with traumatic operations? “My career in medicine for two decades. One must focus,” he said.

Orderlies transported the soldier up the passage and into an ambulance. The vehicle was stationed under a bush. He and the other soldiers were transferred to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, walked up to the doorway to await the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”