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Scrubby foliage conceal the entryway. One sloping timber passageway descends to a brightly lit welcome zone. Inside lies a operating ward, equipped with beds, heart rate sensors and breathing machines. And shelves full of medical equipment, medications and organized stacks of extra garments. In a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they weave in the air above.

Medical personnel at an subterranean medical center observe a screen showing Russian suicide and surveillance UAVs in the area.

Welcome to Ukraine’s secret underground medical facility. The facility opened in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “We are 6 metres below the earth. It’s the most secure way of providing help to our wounded soldiers. And it keeps healthcare workers safe,” said the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from devastating leg injuries necessitating surgical removal, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our cases are from FPVs. We encounter minimal gunshot wounds. This is an age of drones and a different kind of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating wounded troops in eastern Ukraine.

On one afternoon recently, a group of three military members limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had torn a small hole in his leg. “War is terrible. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians released a another explosive on him.” He added: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Ours and the enemy's.”

Dvorskyi explained his squad endured 43 days in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. Necessary provisions came by quadcopter: food and water. A week following he was injured, he walked five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. Following care, a nurse gave him fresh civilian clothes: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, stated a first-person view drone ripped a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly became black. I lost sensation anything or any sound,” he said. “I think I was lucky to survive. My cousin has been lost. There are ongoing explosions.” A builder employed in Lithuania, Filipchuk said he had come back to his homeland and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as doctors placed him on a bed, took off a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A piece of artillery hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a several months. After that, to go back to my unit. Someone must protect our country,” he said.

Medical staff treat the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Over the past years, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred medical personnel have been killed in almost two thousand assaults. The underground facility is built from multiple steel bunkers, with wooden supports, earth and granular material placed above reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three eight-kilogram TNT charges released by aerial means.

A major industrial group, which funded the construction, intends to erect 20 facilities in total. The head of the nation's national security council and ex- military leader, Rustem Umerov, said they would be “critically essential for saving the survival of our military and supporting defenders on the frontline.” The organization referred to the initiative as the “largest-scale and demanding” it had undertaken since the enemy's invasion.

One of the centre’s operating theatres.

Holovashchenko, explained certain wounded personnel had to wait many hours or even multiple days before they could be transported because of the danger of aerial attacks. “Our facility received a pair of critically ill patients who arrived 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 so long there was no other option.” What is his method with traumatic operations? “My career in medicine for two decades. You have to focus,” he remarked.

Medical assistants transported the soldier up the passage and into an ambulance. The vehicle was parked beneath a shrub. The patient and the two other soldiers were taken to the urban center of a major city for further treatment. The underground medical team paused for rest. The facility's ginger cat, Vasilevs, walked up to the entrance to greet the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”