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Sparse trees conceal the entrance. A descending wooden tunnel descends to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, heart rate sensors and ventilators. Plus cabinets full of healthcare supplies, medications and neat piles of extra garments. In a staff room with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital staff at an subterranean hospital observe a monitor showing Russian suicide and reconnaissance UAVs in the region.

Welcome to the nation's secret underground medical facility. The facility began operations in August and is the second such installation, located 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. This is the most secure way of delivering care to our wounded military personnel. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which release explosives with lethal precision. “Ninety per cent of our patients are from FPVs. We encounter few bullet injuries. It’s an age of drones and a different kind of conflict,” the surgeon said.

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

During one afternoon last week, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an FPV explosion had ripped a minor wound in his leg. “War is terrible. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a second explosive on him.” He added: “All structures in the settlement is destroyed. There are UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit endured 43 days in a forest area close to Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their location was on foot. All supplies came by drone: rations and water. A week after he was injured, he traveled 5km (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant gave him new non-military attire: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been lost. There are continuous explosions.” A builder employed in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a bed, took off a stained bandage and treated his recent injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A fragment of artillery struck me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. That will take a few months. Subsequently, to go back to my military group. Our forces has to defend our country,” he affirmed.

Medical staff care for the wounded soldier, who was hit in the back by a fragment of mortar.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is built from four steel bunkers, with timber beams, earth and sand placed above reaching the surface. It can withstand direct hits from 152mm artillery shells and even three 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which funded the building, intends to build 20 units in total. The head of Ukraine’s security agency and former defence minister, the official, said they would be “vitally essential for preserving the lives of our armed forces and supporting defenders on the frontline.” The company described the project as the “most ambitious and challenging” it had undertaken after the enemy's invasion.

One of the facility's surgical rooms.

The surgeon, said certain wounded soldiers had to endure delays hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received two critically ill casualties who came at the early hours. It was necessary to carry out a removal of both limbs on a patient. His bleeding control device had been on for such an extended period there was no other option.” What is his method with severe surgeries? “I’ve been healthcare for two decades. You have to concentrate,” he said.

Orderlies wheeled the soldier through the tunnel and into an ambulance. The transport was stationed beneath a bush. The patient and the two other soldiers were transferred to the city of a major city for further treatment. The underground hospital staff took a break. The facility's ginger cat, Vasilevs, padded up to the entrance to await the incoming patients. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”