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Sparse trees hide the entryway. One sloping wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus cabinets stocked of medical equipment, medications and neat piles of extra garments. In a break area with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the air above.

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

Welcome to the nation's secret below-ground hospital. This center opened in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “We are 6 metres under the earth. This is the most secure way of providing help to our wounded military personnel. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station handles 30-40 casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Some patients can walk. Almost all are the victims of enemy FPV drones, which drop explosives with deadly precision. “90% of our cases are from first-person view drones. We encounter few gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for treating wounded troops in the eastern region.

On one afternoon last week, a group of three military members limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an first-person view drone blast had torn a minor wound in his limb. “War is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He fell down. Subsequently the enemy forces released a second grenade on him.” He added: “Everything in the settlement is destroyed. We see UAVs everywhere and casualties. Our side's and theirs.”

The soldier explained his squad spent over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their position was on foot. All supplies arrived by drone: rations and drinking water. Seven days following he was injured, he traveled 5km (about 3 miles), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a nurse gave him fresh non-military attire: a shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a FPV drone ripped a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel anything or hear anything,” he said. “I think I was fortunate to survive. A relative has been killed. There are continuous explosions.” A construction worker working in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a bloody 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 piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to return to my unit. Our forces has to protect our country,” he said.

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

Since 2022, Russia has consistently attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 medical personnel have been killed in almost two thousand assaults. This subterranean hospital is built from four steel bunkers, with wooden supports, soil and granular material placed above up to ground level. It is designed to resist impacts from 152mm artillery shells and even three eight-kilogram explosive devices released by drone.

The Ukrainian industrial group, which funded the construction, plans to build 20 units in total. A senior official of Ukraine’s national security council and ex- military leader, the official, declared they would be “vitally important for preserving the survival of our armed forces and supporting defenders on the frontline.” The company referred to the initiative as the “most ambitious and challenging” it had implemented after the enemy's invasion.

One 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 evacuated due to the threat of aerial attacks. “We had a pair of critically ill casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. The soldier's tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Orderlies transported Mykolaichuk up the passage and into an ambulance. The vehicle was stationed beneath a shrub. He and the other military members were taken to the city of a major city for further treatment. The subterranean medical team paused for rest. The facility's orange feline, the mascot, walked up to the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”