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Scrubby foliage conceal the entryway. One descending wooden tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a laundry appliance and kettle, doctors monitor a screen. It shows the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital staff at an underground hospital observe a monitor showing Russian suicide and surveillance drones in the region.

Welcome to Ukraine’s secret below-ground medical facility. The facility began operations in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure way of providing help to our injured military personnel. It also ensures healthcare workers protected,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a each day. Cases differ widely. Some have devastating leg injuries requiring amputations, or severe abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which release grenades with lethal accuracy. “90% of our patients are from FPVs. We see minimal bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major the senior surgeon at the underground facility for treating injured soldiers in the eastern region.

During one afternoon recently, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a minor wound in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Subsequently the enemy forces released a second explosive on him.” He added: “All structures in the village is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi said his unit endured 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to get to their position was by walking. All supplies arrived by drone: food and water. Seven days after he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, said a FPV aerial device caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a drone blast had left him with a head injury. “My position was in a trench shelter. It suddenly became black. I lost sensation anything or hear anything,” he explained. “I believe I was lucky to survive. My cousin has been lost. There are ongoing detonations.” A builder employed in a neighboring country, Filipchuk said he had returned to his homeland and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, took off a stained bandage and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to call his family member. “A fragment of mortar hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to return to my military group. Our forces must defend our country,” he said.

Doctors treat Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Over the past years, Russia has consistently targeted medical centers, clinics, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been fatally attacked in almost 2,000 attacks. The underground facility is constructed from multiple steel bunkers, with wooden supports, earth and granular material placed above reaching the surface. It is designed to resist impacts from 152mm artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the building, plans to build 20 units in all. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “critically essential for saving the lives of our armed forces and assisting defenders on the frontline.” The company described the initiative as the “largest-scale and challenging” it had implemented after the enemy's invasion.

One of the facility's operating theatres.

Holovashchenko, said some injured soldiers had to endure delays hours or even days before they could be transported due to the threat of air assaults. “We had two severely injured casualties who arrived at 3am. It was necessary to perform a removal of both limbs on a patient. The soldier's bleeding control device had been applied for so long there was no other option.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. One must concentrate,” he remarked.

Orderlies transported the soldier through the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the other soldiers were taken to the urban center of Dnipro for additional medical care. The subterranean hospital staff paused for rest. The facility's orange feline, the mascot, walked toward the doorway to await the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko said. “The work is continuous.”