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Sparse foliage hide the entrance. A descending timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, physicians monitor a display. The screen reveals the movements of Russian spy drones as they weave in the air above.

Medical personnel at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance UAVs in the area.

This is the nation's secret underground hospital. The facility opened in the eighth month and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “We are six meters under the ground. It’s the most secure method of providing help to our injured military personnel. It also ensures medical personnel protected,” stated the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Others can walk. Almost all are the casualties of enemy FPV aerial devices, which drop explosives with lethal accuracy. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an age of drones and a new type of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the underground facility for treating injured troops in eastern Ukraine.

During one afternoon last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an first-person view drone explosion had torn a minor wound in his leg. “War is horrific. My comrade beside me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the Russians released a another explosive on him.” He continued: “Everything in the settlement is destroyed. There are drones everywhere and casualties. Ours and theirs.”

The soldier said his squad endured 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture since last year. The only way to get to their location was by walking. Necessary provisions came by drone: rations and drinking water. Seven days after he was injured, he walked 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his physical condition. Following care, a nurse provided him with new civilian clothes: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said 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 said. “I believe I was lucky to survive. A relative has been lost. We face ongoing explosions.” A builder working in a neighboring country, he said he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a bed, removed a bloody bandage and cleaned his recent injury from fragments. Covered in a thermal sheet, he used a cellphone to ring his sister. “A piece of mortar hit me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. Subsequently, to go back to my unit. Our forces must defend our country,” he said.

Doctors care for the wounded soldier, who was injured in the dorsal area by a piece of mortar.

Over the past years, Russia has consistently attacked hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in almost two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, earth and sand placed above up to the surface. It is designed to resist direct hits from 152mm projectiles and even three 8kg explosive devices released by aerial means.

The Ukrainian steel and mining company, which financed the construction, intends to build 20 units in total. A senior official of the nation's security agency and ex- military leader, Rustem Umerov, said they would be “vitally important for saving the survival of our armed forces and assisting defenders on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain wounded soldiers had to endure delays many hours or even days before they could be transported because of the threat of aerial attacks. “Our facility received two critically ill casualties who arrived at 3am. It was necessary to perform a double amputation on a patient. The soldier's bleeding control device had been on for such an extended period there was no other option.” What is his method with traumatic operations? “I’ve been medicine for two decades. You have to focus,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an ambulance. The vehicle was stationed under a bush. The patient and the two other military members were transferred to the city of Dnipro for further treatment. The subterranean medical team took a break. The facility's ginger cat, Vasilevs, walked toward the doorway to await the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”