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Sparse foliage conceal the entrance. One sloping timber passageway leads down to a well-illuminated reception area. There is a operating ward, equipped with gurneys, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. In a staff room with a washing machine and kettle, doctors monitor a screen. It shows the movements of Russian surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground hospital observe a screen showing Russian kamikaze and reconnaissance drones in the region.

This is Ukraine’s covert below-ground medical facility. This center began operations in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “We are 6 metres below the earth. It’s the safest method of providing help to our injured military personnel. And it keeps medical personnel protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a day. Their conditions vary. Some have devastating leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian 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 few bullet injuries. This is an era of unmanned aircraft and a different kind of war,” the surgeon explained.

Maj the senior surgeon at the subterranean facility for caring for injured troops in the eastern region.

During one day last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone blast had ripped a minor wound in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Then the enemy forces released a second explosive on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and casualties. Ours and theirs.”

The soldier explained his squad spent over a month in a wooded zone close to the city, which enemy forces has been attempting to capture for many months. The only way to reach their location was by walking. All supplies arrived by drone: rations and water. Seven days after he was hurt, he walked 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his physical condition. Following care, a nurse provided him with fresh civilian clothes: a shirt and a set of light-colored jeans.

The soldier, twenty-eight, stated a FPV aerial device caused a small hole in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he explained. “I think I was fortunate to remain alive. A relative has been lost. We face ongoing explosions.” A builder employed in Lithuania, he noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, removed a stained dressing and treated his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his family member. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my unit. Our forces must protect 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, obstetric units and emergency vehicles. According to human rights groups, 261 medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, soil and sand placed above reaching ground level. It is designed to resist impacts from large-caliber projectiles and even multiple eight-kilogram TNT charges released by drone.

The Ukrainian industrial group, which financed the construction, plans to erect twenty facilities in all. A senior official of Ukraine’s security agency and former military leader, the official, declared they would be “vitally essential for saving the survival of our military and supporting troops on the frontline.” The organization referred to the project as the “largest-scale and demanding” it had undertaken after the enemy's military offensive.

One of the centre’s surgical rooms.

Holovashchenko, said certain wounded soldiers had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had a pair of severely injured patients who came at 3am. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” What is his method with severe operations? “My career in medicine for 20 years. One must concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The transport was parked under a bush. The patient and the two other soldiers were transferred to the urban center of a major city for further treatment. The underground medical team paused for rest. The facility's orange feline, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates active 24 hours a day,” the surgeon stated. “It doesn’t stop.”