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Sparse foliage hide the entryway. One descending wooden tunnel leads down to a brightly lit reception area. Inside lies a operating ward, equipped with beds, cardiac monitors and breathing machines. And cabinets stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, physicians keep an eye on a display. It shows the flight patterns of enemy surveillance UAVs as they weave in the air above.

Medical staff at an subterranean medical center observe a screen showing enemy suicide and reconnaissance UAVs in the region.

Welcome to the nation's covert below-ground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the urban area of a key location in the Donetsk region. “We are six meters below the earth. It’s the safest method of delivering care to our wounded military personnel. And it keeps medical personnel safe,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of Russian FPV drones, which drop grenades with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

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

On one day recently, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his leg. “Conflict is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the enemy forces dropped a another explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs everywhere and casualties. Our side's and theirs.”

The soldier said his unit endured 43 days in a wooded zone close to the city, which enemy forces has been trying to seize since last year. The only way to reach their location was by walking. All supplies arrived by drone: food and water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a nurse provided him with new civilian clothes: a shirt and a set of pale denim trousers.

The soldier, 28, said a FPV aerial device ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I believe I was fortunate to survive. A relative has been killed. We face continuous explosions.” A construction worker employed in Lithuania, Filipchuk said he had returned to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as doctors laid him on a medical cot, removed a stained bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A piece of artillery hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to return to my military group. Someone must defend our country,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has repeatedly attacked hospitals, clinics, maternity wards and emergency vehicles. Per international monitors, 261 medical personnel have been fatally attacked in almost two thousand attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material placed above up to ground level. It is designed to resist impacts from 152mm artillery shells and even three 8kg explosive devices released by drone.

A major steel and mining company, which financed the building, intends to build twenty units in all. A senior official of the nation's security agency and former defence minister, the official, said they would be “vitally essential for preserving the survival of our armed forces and supporting defenders on the battlefront.” The company referred to the project as the “largest-scale and challenging” it had implemented since Russia’s invasion.

One of the facility's surgical rooms.

The surgeon, said some injured soldiers had to endure delays hours or even days before they could be transported because of the threat of aerial attacks. “Our facility received a pair of severely injured patients who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His tourniquet had been on for so long there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for two decades. One must concentrate,” he remarked.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The transport was parked under a shrub. He and the two other military members were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, the mascot, walked toward the doorway to greet the next arrivals. “We are open around the clock,” Holovashchenko stated. “It doesn’t stop.”