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Sparse foliage conceal the entryway. One descending wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground medical center look at a monitor showing enemy kamikaze and surveillance UAVs in the region.

Welcome to the nation's secret below-ground hospital. This center began operations in the eighth month and is the second of its kind, located in the eastern part of the country close to the combat zone and the urban area of a key location in the Donetsk region. “We are 6 metres under the ground. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

This medical station handles 30-40 patients a day. Cases differ widely. Some have catastrophic leg injuries necessitating amputations, or severe abdominal injuries. Some patients can move on their own. Almost all are the victims of enemy FPV aerial devices, which release grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the doctor said.

Major Oleksandr Holovashchenko at the underground installation for treating injured troops in eastern Ukraine.

On one day recently, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a minor wound in his limb. “War is terrible. My comrade beside me, Vasyl, was killed,” he stated. “He fell down. Subsequently the enemy forces dropped a second grenade on him.” He added: “Everything in the settlement is demolished. We see UAVs all around and bodies. Our side's and the enemy's.”

Dvorskyi said his squad endured 43 days in a wooded zone close to the city, which Russia has been attempting to capture for many months. Sole access to get to their location was by walking. Necessary provisions came by quadcopter: food and water. Seven days after he was injured, he walked 5km (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a set of light-colored jeans.

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

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had left him with concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. There are continuous detonations.” A construction worker working in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as doctors laid him on a bed, took off a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of mortar hit me. It was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. This may require a few months. Subsequently, to return to my military group. Someone must protect our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a piece of artillery shell.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. Per human rights groups, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is constructed from four reinforced shelters, with wooden supports, earth and granular material laid on top up to ground level. It can withstand impacts from 152mm artillery shells and even three eight-kilogram explosive devices released by aerial means.

A major industrial group, which funded the building, plans to build twenty facilities in all. The head of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “vitally essential for saving the survival of our military and supporting troops on the battlefront.” The company described the initiative as the “largest-scale and challenging” it had implemented since Russia’s military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said some injured personnel had to wait hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had a pair of critically ill patients who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been medicine for two decades. You have to focus,” he said.

Medical assistants transported the soldier through the tunnel and into an ambulance. The transport was stationed under a bush. The patient and the other soldiers were transferred to the city of Dnipro for additional medical care. The underground medical team took a break. The facility's orange feline, Vasilevs, padded up to the doorway to await the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “The work is continuous.”