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Scrubby foliage conceal the entryway. One descending wooden passageway descends to a well-illuminated welcome zone. There is a operating ward, equipped with gurneys, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital personnel at an subterranean medical center look at a monitor displaying Russian suicide and surveillance drones in the region.

This is Ukraine’s secret below-ground medical facility. The facility opened in August and is the second such installation, located 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 safest way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a each day. Cases differ widely. Some have devastating leg injuries requiring amputations, or severe abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian FPV aerial devices, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We see minimal gunshot wounds. It’s an age of drones and a different kind of war,” the surgeon explained.

Maj the senior surgeon at the subterranean facility for treating injured troops in eastern Ukraine.

During one day last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a minor wound in his leg. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He continued: “All structures in the village is demolished. We see UAVs all around and casualties. Our side's and the enemy's.”

The soldier explained his unit spent over a month in a forest area close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was on foot. Necessary provisions came by quadcopter: food and drinking water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a nurse provided him with new non-military attire: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly became black. I lost sensation anything or hear anything,” he said. “I believe I was lucky to survive. My cousin has been lost. There are continuous explosions.” A builder employed in Lithuania, he noted he had returned to Ukraine and enlisted to fight days before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as doctors placed him on a medical cot, took off a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to call his sister. “A piece of mortar struck me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to return to my military group. Our forces must defend our country,” he said.

Medical staff care for the wounded soldier, who was injured in the back by a fragment of mortar.

Over the past years, Russia has consistently targeted hospitals, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been killed in nearly two thousand attacks. The underground facility is constructed from four reinforced shelters, with timber beams, soil and granular material laid on top up to the surface. It can withstand direct hits from 152mm artillery shells and even three eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which financed the construction, intends to build twenty units in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally important for preserving the lives of our military and assisting troops on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had implemented since Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, explained some injured soldiers had to endure delays hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had a pair of critically ill casualties who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been applied for such an extended period there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for 20 years. You have to focus,” he said.

Medical assistants wheeled the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the other military members were taken to the city of a major city for further treatment. The subterranean hospital staff took a break. The hospital’s orange feline, Vasilevs, padded up to the entrance to greet the incoming patients. “We are active around the clock,” the surgeon said. “The work is continuous.”