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Sparse trees hide the entrance. One sloping timber passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with beds, heart rate sensors and ventilators. And shelves full of medical equipment, drugs and neat piles of spare clothes. In a break area with a washing machine and kettle, doctors monitor a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an subterranean hospital observe a screen showing enemy kamikaze and surveillance UAVs in the region.

This is the nation's covert underground hospital. This center began operations in August and is the second such installation, located in eastern Ukraine close to the combat zone and the city of Pokrovsk in Donetsk oblast. “We are six meters under the earth. This is the most secure way of delivering care to our injured military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Cases differ widely. Some have devastating limb trauma requiring surgical removal, or serious abdominal injuries. Others can move on their own. Almost all are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with deadly precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an era of drones and a different kind of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for caring for injured soldiers in eastern Ukraine.

During one afternoon last week, three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his leg. “Conflict is horrific. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He continued: “All structures in the village is destroyed. We see drones everywhere and casualties. Ours and theirs.”

Dvorskyi said his squad spent 43 days in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture for many months. The only way to get to their location was by walking. Necessary provisions came by quadcopter: food and drinking water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant gave him new civilian clothes: a shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a first-person view drone ripped a small hole in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. It suddenly became black. I lost sensation anything or hear anything,” he said. “I think I was fortunate to remain alive. My cousin has been killed. There are ongoing explosions.” A builder working in a neighboring country, Filipchuk said he had returned to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a bed, removed a bloody bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of artillery hit me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a few months. After that, to return to my unit. Someone must defend our country,” he affirmed.

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

Over the past years, enemy forces has repeatedly attacked hospitals, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been killed in nearly two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, soil and granular material laid on top reaching ground level. It can withstand direct hits from 152mm artillery shells and even three eight-kilogram explosive devices released by drone.

A major steel and mining company, which financed the construction, intends to erect 20 facilities in all. A senior official of Ukraine’s national security council and former defence minister, Rustem Umerov, declared they would be “critically essential for saving the lives of our armed forces and supporting troops on the frontline.” The organization described the project as the “largest-scale and demanding” it had undertaken after the enemy's invasion.

One of the facility's operating theatres.

The surgeon, said some injured soldiers had to wait many hours or even days before they could be transported because of the danger of air assaults. “We had two severely injured casualties who arrived at the early hours. It was necessary to perform a double amputation on one of them. 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? “My career in medicine for 20 years. One must focus,” he remarked.

Medical assistants wheeled the soldier up the passage and into an ambulance. The transport was parked under a bush. The patient and the two other military members were taken to the city of a major city for additional medical care. The subterranean hospital staff took a break. The facility's orange feline, the mascot, padded toward the doorway to await the next arrivals. “We are active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”