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Scrubby foliage conceal the entrance. A descending wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, medications and neat piles of spare clothes. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. It shows the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an subterranean medical center look at a monitor showing Russian suicide and surveillance UAVs in the region.

Welcome to the nation's secret underground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the safest way of delivering care to our injured soldiers. And it keeps medical personnel safe,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have devastating limb trauma requiring amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of Russian FPV aerial devices, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We see few bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured soldiers in eastern Ukraine.

During one day last week, three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the village is demolished. There are UAVs everywhere and casualties. Our side's and theirs.”

The soldier explained his squad endured 43 days in a forest area near Pokrovsk, which Russia has been attempting to capture for many months. The only way to get to their location was by walking. Necessary provisions came by quadcopter: rations and water. A week following he was hurt, he walked 5km (roughly three miles), requiring three hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant gave him new civilian clothes: a T-shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a first-person view drone ripped a small hole in his lower limb.

Another patient, 38-year-old a serviceman, said a drone blast had left him with a head injury. “I was in a dugout. It suddenly became black. I couldn’t feel any feeling or any sound,” he said. “I believe I was lucky to remain alive. My cousin has been lost. We face continuous explosions.” A builder employed in Lithuania, he noted he had come back to his homeland and enlisted to serve days before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff placed him on a medical cot, removed a bloody dressing and cleaned his two-day-old injury from fragments. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a several months. Subsequently, to return to my military group. Someone has to defend our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Over the past years, enemy forces has consistently attacked hospitals, clinics, obstetric units and ambulances. Per human rights groups, over two hundred health workers have been killed in nearly 2,000 assaults. The underground facility is built from multiple steel bunkers, with wooden supports, earth and sand laid on top up to the surface. It can withstand impacts from large-caliber artillery shells and even three 8kg TNT charges released by aerial means.

A major steel and mining company, which financed the building, plans to erect twenty units in all. The head of the nation's national security council and ex- military leader, Rustem Umerov, said they would be “vitally essential for saving the survival of our armed forces and assisting troops on the battlefront.” The organization referred to the project as the “most ambitious and challenging” it had implemented since the enemy's invasion.

One of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to endure delays many hours or even multiple days before they could be transported due to the threat of aerial attacks. “Our facility received two severely injured patients who arrived at 3am. I had to perform a double amputation on a patient. The soldier's bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. You have to focus,” he remarked.

Orderlies wheeled the soldier through the passage and into an ambulance. The transport was stationed beneath a bush. The patient and the two other soldiers were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff paused for rest. The hospital’s ginger cat, Vasilevs, padded up to the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko said. “The work is continuous.”