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Scrubby foliage hide the entrance. A sloping timber passageway leads down to a brightly lit welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and ventilators. Plus cabinets stocked of medical equipment, medications and organized stacks of extra garments. In a staff room with a washing machine and kettle, physicians monitor a screen. It shows the movements of Russian spy drones as they weave in the sky above.

Medical staff at an underground medical center look at a screen displaying Russian suicide and reconnaissance drones in the area.

Welcome to the nation's secret underground medical facility. The facility began operations in the eighth month and is the second of its kind, located in eastern Ukraine close to the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres under the ground. It’s the safest method of providing help to our wounded soldiers. It also ensures medical personnel safe,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or serious stomach wounds. Some patients can move on their own. The vast majority are the casualties of Russian first-person view (FPV) drones, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in eastern Ukraine.

On one afternoon last week, a group of three military members limped into the facility. The most lightly injured, 28-year-old one soldier, reported an FPV explosion had ripped a minor wound in his limb. “War is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces released a second grenade on him.” He continued: “Everything in the village is demolished. There are UAVs all around and casualties. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days in a wooded zone near Pokrovsk, which Russia has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions arrived by drone: food and drinking water. A week after he was injured, he traveled five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a medical attendant gave him fresh civilian clothes: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, 28, said a FPV drone caused a small hole in his leg.

A different casualty, 38-year-old a serviceman, said a drone blast had resulted in 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 remain alive. A relative has been killed. We face ongoing detonations.” A construction worker working in a neighboring country, Filipchuk said he had returned to his homeland and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff placed him on a bed, removed a bloody bandage and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to ring his sister. “A piece of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. After that, to go back to my military group. Someone has to protect our country,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted medical centers, clinics, maternity wards and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in nearly two thousand assaults. The underground facility is built from four reinforced shelters, with timber beams, earth and granular material placed above up to the surface. It is designed to resist impacts from large-caliber projectiles and even multiple 8kg explosive devices released by drone.

The Ukrainian industrial group, which funded the building, plans to erect 20 facilities in all. The head of the nation's security agency and former military leader, Rustem Umerov, declared they would be “critically essential for saving the survival of our armed forces and assisting troops on the frontline.” The organization referred to the project as the “most ambitious and challenging” it had implemented since Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, said some wounded soldiers had to endure delays many hours or even multiple days before they could be evacuated due to the threat of air assaults. “Our facility received two critically ill casualties who arrived at 3am. I had to perform a double amputation on a patient. The soldier's tourniquet had been applied for so long there was no other option.” What is his method with traumatic surgeries? “My career in healthcare for two decades. One must concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The transport was parked under a shrub. He and the other soldiers were transferred to the city of Dnipro for further treatment. The subterranean hospital staff took a break. The facility's orange feline, the mascot, walked up to the entrance to greet the next arrivals. “We are active around the clock,” the surgeon stated. “It doesn’t stop.”