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Scrubby trees hide the entryway. A descending timber passageway leads down to a brightly lit welcome zone. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a washing machine and kettle, physicians keep an eye on a screen. It shows the movements of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance drones in the region.

This is Ukraine’s covert underground hospital. This center opened in the eighth month and is the second such installation, located in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. It’s the most secure method of delivering care to our injured soldiers. It also ensures healthcare workers protected,” said the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have devastating limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. Almost all are the victims of enemy FPV aerial devices, which release explosives with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We see minimal bullet injuries. This is an era of drones and a new type of war,” the doctor said.

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

During one afternoon last week, three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his limb. “War is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Subsequently the Russians released a another explosive on him.” He added: “Everything in the settlement is demolished. There are drones all around and casualties. Ours and theirs.”

The soldier said his unit spent 43 days in a wooded zone near Pokrovsk, which Russia has been attempting to capture for many months. The only way to reach their position was by walking. Necessary provisions came by drone: food and drinking water. A week after he was hurt, he walked five kilometers (roughly three miles), requiring three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse gave him new non-military attire: a shirt and a pair of pale jeans.

The soldier, twenty-eight, said a FPV drone caused a small hole in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel any feeling or any sound,” he explained. “I believe I was lucky to survive. My cousin has been lost. We face continuous detonations.” A builder working in Lithuania, he said he had come back to his homeland and enlisted to fight days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff placed him on a bed, took off a bloody dressing and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to call his sister. “A piece of artillery hit me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. This may require a few months. Subsequently, to return to my unit. Our forces has to protect our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Over the past years, Russia has consistently attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 health workers have been killed in nearly two thousand assaults. The underground facility is built from multiple steel bunkers, with wooden supports, earth and granular material laid on top reaching ground level. It is designed to resist impacts from 152mm artillery shells and even three eight-kilogram TNT charges dropped by aerial means.

A major steel and mining company, which funded the construction, plans to build 20 units in all. A senior official of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “critically essential for preserving the survival of our military and supporting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken since Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, explained some wounded soldiers had to endure delays hours or even days before they could be evacuated because of the danger of aerial attacks. “We had a pair of critically ill patients who came at the early hours. It was necessary to perform a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants transported the soldier through the tunnel and into an ambulance. The vehicle was parked beneath a bush. The patient and the other military members were transferred to the city of a major city for additional medical care. The underground medical team paused for rest. The facility's ginger cat, the mascot, padded up to the entrance to await the next arrivals. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”