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Sparse trees hide the entrance. A descending timber tunnel leads down to a well-illuminated reception area. There is a operating ward, outfitted with beds, heart rate sensors and ventilators. And cabinets stocked of medical equipment, medications and neat piles of extra garments. In a break area with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

Hospital personnel at an underground medical center observe a monitor showing Russian suicide and surveillance UAVs in the region.

Welcome to the nation's covert 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 not far from the frontline and the city of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. This is the safest way of delivering care to our injured military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 patients a day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which release explosives with lethal accuracy. “90% of our patients are from FPVs. We see minimal gunshot wounds. This is an era of drones and a different kind of war,” the doctor said.

Major Oleksandr Holovashchenko at the subterranean installation for treating wounded troops in eastern Ukraine.

On one afternoon recently, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his limb. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second grenade on him.” He added: “Everything in the village is demolished. There are UAVs everywhere and casualties. Ours and theirs.”

The soldier said his unit endured 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. The only way to get to their location was by walking. All supplies came by drone: food and drinking water. A week after he was injured, he traveled five kilometers (about 3 miles), taking several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a nurse gave him fresh non-military attire: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, 28, said a FPV aerial device ripped a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly became black. I couldn’t feel anything or hear anything,” he said. “I think I was lucky to survive. A relative has been lost. There are continuous detonations.” A construction worker working in a neighboring country, he said he had returned to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a medical cot, took off a bloody bandage and treated his recent injury from fragments. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. This may require a few months. Subsequently, to go back to my unit. Our forces has to protect our country,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently targeted hospitals, health facilities, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been fatally attacked in nearly 2,000 assaults. The underground facility is constructed from multiple steel bunkers, with timber beams, soil and granular material laid on top up to ground level. It can withstand direct hits from large-caliber projectiles and even three 8kg explosive devices released by aerial means.

A major steel and mining company, which funded the building, intends to build twenty units in total. A senior official of the nation's national security council and former military leader, Rustem Umerov, declared they would be “vitally essential for preserving the lives of our armed forces and assisting defenders on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken since Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained certain injured soldiers had to wait many hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had a pair of critically ill patients who came at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Orderlies transported the soldier through the passage and into an emergency vehicle. The vehicle was parked under a bush. The patient and the two other soldiers were taken to the city of Dnipro for further treatment. The underground medical team took a break. The facility's orange feline, Vasilevs, walked toward the doorway to greet the next arrivals. “Our facility operates active around the clock,” Holovashchenko said. “It doesn’t stop.”