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Scrubby trees conceal the entrance. A sloping wooden tunnel leads down to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets stocked of healthcare supplies, drugs and neat piles of extra garments. Within a break area with a washing machine and kettle, doctors monitor a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground medical center observe a monitor showing Russian suicide and reconnaissance UAVs in the region.

Welcome to Ukraine’s secret below-ground hospital. The facility opened in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are six meters below the ground. This is the most secure way of delivering care to our wounded military personnel. It also ensures medical personnel protected,” stated the facility's surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 patients a day. Their conditions vary. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian FPV aerial devices, which drop grenades with lethal accuracy. “90% of our patients are from first-person view drones. We see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of war,” the doctor explained.

Major the senior surgeon at the underground facility for treating injured soldiers in the eastern region.

On one day last week, a group of three military members limped into the hospital. The most lightly injured, 28-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “Conflict is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the enemy forces dropped a another explosive on him.” He continued: “All structures in the village is demolished. We see drones everywhere and casualties. Our side's and theirs.”

The soldier explained his squad spent 43 days in a wooded zone near the city, which enemy forces has been attempting to capture since last year. The only way to reach their position was on foot. All supplies came by quadcopter: rations and water. Seven days following he was injured, he walked 5km (roughly three miles), taking several hours, to a point where an military transport was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant gave him new civilian clothes: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV drone ripped a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to remain alive. My cousin has been killed. We face ongoing explosions.” A construction worker working in Lithuania, Filipchuk noted he had returned to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a medical cot, took off a bloody dressing and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a cellphone to ring his sister. “A fragment of mortar hit me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. After that, to return to my unit. Someone must protect our nation,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has repeatedly targeted hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and granular material laid on top up to the surface. It can withstand direct hits from 152mm artillery shells and even multiple 8kg TNT charges released by drone.

A major industrial group, which funded the building, intends to erect 20 units in all. A senior official of the nation's security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for saving the survival of our military and assisting troops on the battlefront.” The organization referred to the initiative as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained some injured soldiers had to endure delays many hours or even days before they could be evacuated due to the danger of aerial attacks. “Our facility received two severely injured casualties who came at the early hours. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with severe surgeries? “My career in medicine for 20 years. One must concentrate,” he said.

Orderlies wheeled the soldier up the tunnel and into an emergency vehicle. The vehicle was parked under a bush. He and the two other military members were taken to the city of a major city for additional medical care. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, walked up to the entrance to await the next arrivals. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”