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Scrubby foliage conceal the entryway. One descending timber passageway leads down to a brightly lit reception area. There is a operating ward, equipped with gurneys, heart rate sensors and breathing machines. And cabinets full of medical equipment, medications and neat piles of extra garments. In a staff room with a washing machine and hot water heater, doctors monitor a screen. It shows the movements of enemy surveillance UAVs as they weave in the air above.

Hospital personnel at an underground medical center look at a screen showing enemy kamikaze and surveillance UAVs in the area.

This is Ukraine’s secret underground medical facility. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the ground. This is the safest way of delivering care to our wounded military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Their conditions vary. Some have catastrophic leg injuries requiring amputations, or severe stomach wounds. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) drones, which drop grenades with lethal accuracy. “Ninety per cent of our cases are from FPVs. We encounter minimal gunshot wounds. This is an age of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the underground installation for caring for wounded troops in the eastern region.

On one afternoon recently, a group of three military members limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a minor wound in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was killed,” he stated. “He fell down. Then the Russians released a another explosive on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and bodies. Ours and theirs.”

Dvorskyi said his unit spent over a month in a forest area close to Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to get to their location was on foot. All supplies came by quadcopter: food and drinking water. Seven days following he was injured, he traveled five kilometers (roughly three miles), taking several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his physical condition. After treatment, a nurse provided him with new civilian clothes: a shirt and a set of pale jeans.

Artem Dvorskiy, 28, stated a first-person view aerial device ripped a small hole in his leg.

A different casualty, 38-year-old a serviceman, recounted a drone blast had left him with concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I think I was lucky to survive. My cousin has been lost. We face continuous detonations.” A builder employed in a neighboring country, he said he had returned to Ukraine and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a medical cot, took off a bloody dressing and treated his two-day-old shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to ring his sister. “A fragment of mortar hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. After that, to return to my military group. Someone has to protect our nation,” he said.

Doctors care for the wounded soldier, who was injured in the back by a piece of artillery shell.

Over the past years, Russia has consistently targeted medical centers, clinics, maternity wards and emergency vehicles. According to international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. The underground facility is built from four reinforced shelters, with wooden supports, earth and granular material placed above up to the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg explosive devices dropped by aerial means.

A major industrial group, which funded the construction, plans to erect 20 units in total. The head of the nation's national security council and former military leader, Rustem Umerov, said they would be “critically important for preserving the survival of our military and supporting troops on the battlefront.” The organization referred to the initiative as the “most ambitious and demanding” it had implemented after Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, said some wounded soldiers had to endure delays hours or even days before they could be evacuated due to the danger of aerial attacks. “Our facility received a pair of critically ill patients who arrived at 3am. It was necessary to perform a double amputation on one of them. His bleeding control device had been on for so long there was no other option.” How did he cope with severe operations? “I’ve been medicine for 20 years. One must concentrate,” he remarked.

Orderlies transported Mykolaichuk up the passage and into an emergency vehicle. The vehicle was parked under a bush. He and the two other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded up to the entrance to await the incoming patients. “Our facility operates open around the clock,” the surgeon stated. “It doesn’t stop.”