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Scrubby trees hide the entryway. A descending timber passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus shelves full of medical equipment, medications and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors monitor a screen. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center look at a screen displaying enemy suicide and reconnaissance drones in the region.

This is Ukraine’s secret underground medical facility. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine close to the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits six meters under the ground. This is the most secure way of providing help to our injured military personnel. It also ensures healthcare workers protected,” said the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring amputations, or severe abdominal injuries. Some patients can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which drop explosives with lethal precision. “90% of our patients are from first-person view drones. We see few bullet injuries. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon said.

Major the senior surgeon at the subterranean installation for treating wounded troops in eastern Ukraine.

On one day last week, three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a minor wound in his limb. “War is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces released a another grenade on him.” He added: “All structures in the settlement is demolished. We see drones everywhere and bodies. Ours and theirs.”

Dvorskyi explained his squad endured over a month in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. The only way to get to their position was on foot. All supplies came by quadcopter: rations and drinking water. A week after he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to where an military transport was able to evacuate him. At the clinic, a medic checked his physical condition. After treatment, a medical attendant gave him fresh civilian clothes: a shirt and a pair of pale denim trousers.

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

Another patient, 38-year-old a serviceman, said a drone blast had left him with concussion. “My position was in a dugout. It suddenly became black. I couldn’t feel anything or any sound,” he explained. “I think I was fortunate to remain alive. A relative has been lost. We face ongoing explosions.” A construction worker working in Lithuania, he noted he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the upper body. He expressed pain as doctors placed him on a medical cot, removed a bloody dressing and treated his two-day-old shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to go back to my unit. Someone must protect our country,” he said.

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

Over the past years, Russia has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been fatally attacked in almost two thousand assaults. This subterranean hospital is built from multiple steel bunkers, with wooden supports, soil and granular material placed above up to ground level. It can withstand direct hits from large-caliber projectiles and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, intends to build 20 facilities in total. The head of the nation's security agency and ex- military leader, Rustem Umerov, said they would be “vitally essential for saving the lives of our military and supporting defenders on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken since Russia’s invasion.

An example of the centre’s surgical rooms.

The surgeon, explained some wounded personnel had to endure delays hours or even multiple days before they could be transported because of the threat of aerial attacks. “Our facility received a pair of critically ill casualties who arrived at 3am. It was necessary to carry out a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for two decades. One must focus,” he said.

Orderlies wheeled Mykolaichuk up the passage and into an ambulance. The transport was stationed under a bush. He and the two other soldiers were taken to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked toward the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko stated. “The work is continuous.”