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Scrubby trees hide the entryway. One descending timber tunnel leads down to a well-illuminated reception area. There is a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets full of medical equipment, drugs and neat piles of spare clothes. In a staff room with a washing machine and kettle, physicians keep an eye on a screen. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Medical personnel at an subterranean hospital look at a screen showing enemy kamikaze and reconnaissance UAVs in the region.

Welcome to the nation's secret underground medical facility. The facility opened in August and is the second such installation, located in eastern Ukraine close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the most secure method of delivering care to our injured military personnel. It also ensures medical personnel safe,” said the facility's lead doctor, Major the chief surgeon.

The stabilisation point treats thirty to forty casualties a day. Their conditions vary. Some have catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the casualties of enemy FPV drones, which release grenades with lethal accuracy. “90% of our cases are from FPVs. We encounter few gunshot wounds. It’s an age of drones and a new type of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the underground facility for caring for injured troops in the eastern region.

During one afternoon recently, three military members limped into the hospital. The least severely hurt, 28-year-old one soldier, reported an FPV explosion had ripped a minor wound in his leg. “Conflict is horrific. My comrade next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the enemy forces released a second explosive on him.” He continued: “Everything in the settlement is demolished. We see UAVs everywhere and bodies. Ours and the enemy's.”

The soldier explained his unit spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. All supplies came by quadcopter: food and drinking water. A week after he was injured, he walked five kilometers (roughly three miles), requiring three hours, to a point where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with new non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone ripped a small hole in his leg.

Another patient, 38-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. A relative has been killed. There are continuous explosions.” A builder working in Lithuania, he said he had come back to his homeland and enlisted to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a medical cot, took off a stained dressing and treated his recent shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his sister. “A piece of artillery hit me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. This may require a few months. After that, to go back to my unit. Our forces has to protect our nation,” he affirmed.

Doctors care for the wounded soldier, who was hit in the back by a piece of mortar.

Over the past years, Russia has consistently attacked hospitals, health facilities, obstetric units and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in almost 2,000 assaults. The underground facility is built from four steel bunkers, with timber beams, soil and granular material placed above reaching the surface. It can withstand impacts from 152mm artillery shells and even three 8kg explosive devices dropped by aerial means.

A major steel and mining company, which financed the building, intends to build 20 facilities in all. A senior official of Ukraine’s national security council and ex- defence minister, the official, declared they would be “critically important for saving the lives of our military and assisting defenders on the frontline.” The organization referred to the project as the “most ambitious and challenging” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

Holovashchenko, explained certain wounded personnel had to endure delays many hours or even days before they could be transported because of the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. It was necessary to carry out a removal of both limbs on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “My career in medicine for two decades. You have to concentrate,” he said.

Orderlies transported Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. He and the other military members were taken to the urban center of Dnipro for additional medical care. The subterranean medical team paused for rest. The hospital’s ginger cat, the mascot, padded toward the doorway to greet the next arrivals. “Our facility operates active around the clock,” Holovashchenko said. “The work is continuous.”