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Scrubby trees hide the entrance. One descending timber tunnel descends to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with beds, heart rate sensors and ventilators. And cabinets full of medical equipment, drugs and organized stacks of spare clothes. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the movements of Russian surveillance UAVs as they zigzag in the air above.

Medical personnel at an subterranean medical center observe a monitor displaying enemy kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s covert below-ground 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 combat zone and the urban area of a key location in the Donetsk region. “We are 6 metres under the ground. It’s the safest method of delivering care to our injured military personnel. And it keeps healthcare workers protected,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 patients a day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop explosives with deadly accuracy. “90% of our cases are from FPVs. We see minimal bullet injuries. This is an age of drones and a new type of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the underground facility for caring for injured troops in eastern Ukraine.

On one afternoon recently, a group of three military members walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, said an FPV blast had ripped a minor wound in his limb. “Conflict is horrific. My comrade beside me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He continued: “All structures in the village is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

Dvorskyi explained his unit spent 43 days in a forest area near the city, which enemy forces has been trying to seize for many months. Sole access to get to their location was on foot. All supplies came by drone: food and water. Seven days following he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his vital signs. After treatment, a nurse provided him with new civilian clothes: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, said a first-person view drone caused a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. It suddenly went dark. I couldn’t feel anything or hear anything,” he explained. “I think I was fortunate to survive. A relative has been lost. There are continuous detonations.” A construction worker working in Lithuania, he said he had returned to Ukraine and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors laid him on a medical cot, removed a bloody dressing and treated his recent shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A piece of mortar struck me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. That will take a few months. After that, to go back to my military group. Someone has to protect our country,” he said.

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

Over the past years, enemy forces has consistently targeted medical centers, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred medical personnel have been killed in nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and granular material laid on top up to ground level. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which financed the building, plans to build twenty units in total. The head of the nation's security agency and former defence minister, the official, declared they would be “critically important for preserving the lives of our military and assisting defenders on the frontline.” The company described the project as the “largest-scale and challenging” it had undertaken since the enemy's military offensive.

One of the facility's operating theatres.

Holovashchenko, explained some wounded soldiers had to endure delays many hours or even days before they could be evacuated due to the danger of air assaults. “We had a pair of severely injured casualties who came at 3am. I had to carry out a removal of both limbs on a patient. The soldier's tourniquet had been on for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in medicine for 20 years. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was parked beneath a shrub. He and the other military members were taken to the city of a major city for further treatment. The underground medical team took a break. The facility's orange feline, Vasilevs, padded up to the entrance to greet the next arrivals. “Our facility operates open around the clock,” the surgeon said. “The work is continuous.”