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Scrubby trees conceal the entryway. A sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a display. It shows the movements of enemy spy drones as they weave in the sky above.

Hospital personnel at an subterranean medical center observe a monitor displaying Russian kamikaze and surveillance UAVs in the area.

This is the nation's covert below-ground medical facility. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the urban area of a key location in Donetsk oblast. “We are six meters below the ground. It’s the safest method of delivering care to our wounded military personnel. And it keeps healthcare workers protected,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Their conditions vary. Some have catastrophic leg injuries requiring amputations, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of enemy FPV drones, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for injured soldiers in eastern Ukraine.

During one day recently, three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his limb. “Conflict is horrific. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second grenade on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

The soldier explained his unit endured over a month in a forest area near Pokrovsk, which Russia has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions came by quadcopter: food and water. A week after he was hurt, he traveled 5km (roughly three miles), taking several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a first-person view drone ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he explained. “I think I was lucky to remain alive. A relative has been killed. We face ongoing detonations.” A builder working in Lithuania, Filipchuk said he had returned to his homeland and volunteered to fight shortly before the Russian leader's large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a stained dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to call his family member. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a several months. Subsequently, to return to my military group. Someone must protect our nation,” he affirmed.

Doctors treat the wounded soldier, who was injured in the back by a fragment of artillery shell.

Over the past years, enemy forces has consistently targeted hospitals, clinics, obstetric units and ambulances. Per international monitors, over two hundred health workers have been killed in almost two thousand assaults. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and granular material laid on top up to ground level. It can withstand direct hits from large-caliber projectiles and even multiple eight-kilogram explosive devices released by aerial means.

The Ukrainian steel and mining company, which financed the construction, plans to erect twenty units in all. A senior official of Ukraine’s national security council and ex- defence minister, the official, declared they would be “critically essential for saving the lives of our military and supporting troops on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, said some injured soldiers had to wait many hours or even days before they could be transported because of the threat of air assaults. “Our facility received two severely injured patients who came at the early hours. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been on for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “My career in healthcare for 20 years. One must concentrate,” he said.

Medical assistants transported the soldier through the passage and into an ambulance. The transport was stationed under a shrub. The patient and the other soldiers were transferred to the urban center of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s orange feline, the mascot, walked toward the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko said. “The work is continuous.”