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Scrubby trees conceal the entrance. A descending timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And cabinets full of medical equipment, drugs and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, doctors keep an eye on a screen. The screen reveals the movements of enemy spy drones as they zigzag in the sky above.

Medical personnel at an underground hospital look at a monitor displaying Russian suicide and surveillance UAVs in the area.

This is the nation's covert below-ground medical facility. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. This is the safest method of providing help to our wounded soldiers. And it keeps medical personnel protected,” said the clinic’s surgeon, Major the chief surgeon.

This medical station treats 30-40 casualties a day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which drop explosives with lethal precision. “Ninety per cent of our patients are from FPVs. We encounter minimal bullet injuries. This is an age of drones and a different kind of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for injured troops in the eastern region.

On one day recently, three military members limped into the facility. The most lightly injured, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his leg. “Conflict is terrible. My comrade beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a another grenade on him.” He continued: “Everything in the settlement is destroyed. There are drones all around and casualties. Ours and theirs.”

The soldier explained his unit spent 43 days in a forest area near the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. All supplies came by drone: food and drinking water. A week following he was hurt, he traveled 5km (about 3 miles), requiring several hours, to where an military transport was able to pick him up. At the clinic, a medic assessed his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of light-colored denim trousers.

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

Another patient, 38-year-old a serviceman, said a drone blast had resulted in a head injury. “My position was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he said. “I think I was fortunate to survive. My cousin has been killed. There are continuous explosions.” A construction worker employed in a neighboring country, he noted he had returned to Ukraine and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a bed, removed a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his sister. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. That will take a several months. After that, to go back to my military group. Our forces has to protect our country,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of mortar.

Since 2022, Russia has consistently attacked medical centers, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 medical personnel have been fatally attacked in almost two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and sand laid on top up to the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg explosive devices released by aerial means.

A major steel and mining company, which financed the construction, plans to erect twenty facilities in total. A senior official of the nation's national security council and former defence minister, Rustem Umerov, said they would be “critically important for saving the survival of our military and assisting troops on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had undertaken since Russia’s invasion.

One of the centre’s surgical rooms.

The surgeon, explained certain injured personnel had to endure delays many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received two severely injured patients who arrived at 3am. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been on for such an extended period there was no other option.” What is his method with traumatic surgeries? “I’ve been medicine for two decades. One must concentrate,” he said.

Medical assistants wheeled the soldier through the passage and into an ambulance. The transport was parked beneath a bush. The patient and the two other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, walked toward the entrance to greet the next arrivals. “Our facility operates open 24 hours a day,” Holovashchenko said. “The work is continuous.”