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Scrubby foliage conceal the entryway. A sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, medications and organized stacks of extra garments. Within a staff room with a washing machine and hot water heater, physicians monitor a screen. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Hospital staff at an subterranean medical center look at a screen showing Russian kamikaze and surveillance drones in the area.

Welcome to Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are six meters below the ground. This is the most secure way of delivering care to our wounded military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major the chief surgeon.

This medical station handles 30-40 patients a each day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the victims of enemy first-person view (FPV) drones, which release explosives with deadly precision. “Ninety per cent of our cases are from FPVs. We encounter minimal gunshot wounds. It’s an age of drones and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean installation for caring for injured troops in the eastern region.

On one day last week, three soldiers limped into the facility. The least severely hurt, 28-year-old one soldier, reported an first-person view drone explosion had torn a minor wound in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is destroyed. There are drones all around and bodies. Our side's and theirs.”

The soldier said his unit spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was on foot. All supplies came by quadcopter: food and drinking water. Seven days following he was injured, he traveled five kilometers (about 3 miles), taking several hours, to where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a set of light-colored denim trousers.

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

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. Suddenly it went dark. I lost sensation anything or any sound,” he said. “I believe I was lucky to remain alive. My cousin has been lost. We face continuous detonations.” A builder employed in Lithuania, Filipchuk noted he had come back to his homeland and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the back. He groaned as medical staff laid him on a bed, took off a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A fragment 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 return to my unit. Someone must defend our nation,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has repeatedly attacked hospitals, clinics, maternity wards and ambulances. According to human rights groups, 261 medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and sand placed above reaching the surface. It is designed to resist direct hits from large-caliber artillery shells and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, plans to erect 20 units in all. The head of the nation's national security council and former military leader, the official, declared they would be “critically important for saving the lives of our military and supporting troops on the frontline.” The organization referred to the project as the “largest-scale and challenging” it had undertaken since Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, explained some injured personnel had to wait many hours or even multiple days before they could be evacuated because of the danger of air assaults. “We had a pair of severely injured casualties who came at the early hours. I had to carry out a double amputation on a patient. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with severe surgeries? “I’ve been medicine for two decades. You have to focus,” he said.

Orderlies transported Mykolaichuk through the tunnel and into an ambulance. The vehicle was parked under a shrub. The patient and the two other military members were transferred to the city of Dnipro for additional medical care. The subterranean medical team paused for rest. The facility's ginger cat, Vasilevs, walked toward the entrance to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon said. “It doesn’t stop.”