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Scrubby trees hide the entryway. One descending wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets full of healthcare supplies, medications and organized stacks of spare clothes. In a break area with a laundry appliance and kettle, physicians keep an eye on a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the air above.

Medical staff at an subterranean medical center observe a monitor displaying enemy suicide and surveillance drones in the area.

This is the nation's covert underground medical facility. The facility began operations in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the city of a key location in Donetsk oblast. “We are six meters below the earth. It’s the most secure way of delivering care to our wounded soldiers. And it keeps healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of enemy FPV drones, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We see few gunshot wounds. This is an age of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for caring for wounded troops in eastern Ukraine.

During one afternoon last week, three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV explosion had torn a small hole in his limb. “War is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians released a second grenade on him.” He continued: “Everything in the village is destroyed. There are drones all around and casualties. Ours and the enemy's.”

The soldier said his unit spent over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their position was on foot. Necessary provisions came by drone: food and drinking water. Seven days following he was injured, he traveled five kilometers (roughly three miles), taking several hours, to where an military transport was able to pick him up. At the clinic, a medical staff assessed his vital signs. Following care, a nurse provided him with fresh civilian clothes: a shirt and a pair of pale jeans.

The soldier, twenty-eight, said a FPV drone ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to remain alive. My cousin has been killed. There are continuous explosions.” A builder employed in Lithuania, he said he had returned to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a medical cot, removed a bloody dressing and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. That will take a several months. After that, to return to my military group. Our forces has to protect our nation,” he affirmed.

Medical staff care for the wounded soldier, who was injured in the back by a fragment of artillery shell.

Over the past years, Russia has consistently targeted hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred health workers have been killed in almost 2,000 assaults. The underground facility is constructed from four steel bunkers, with timber beams, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, plans to build 20 units in total. A senior official of the nation's security agency and ex- military leader, the official, declared they would be “critically important for saving the survival of our armed forces and assisting troops on the battlefront.” The organization described the project as the “most ambitious and challenging” it had undertaken after the enemy's invasion.

One of the centre’s surgical rooms.

Holovashchenko, said certain injured soldiers had to wait many hours or even days before they could be evacuated because of the threat of aerial attacks. “Our facility received two severely injured casualties who came at the early hours. I had to carry out a double amputation on one of them. The soldier's tourniquet had been on for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in healthcare for two decades. You have to focus,” he said.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. 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 underground medical team paused for rest. The facility's orange feline, the mascot, walked up to the entrance to greet the incoming patients. “We are open 24 hours a day,” the surgeon stated. “It doesn’t stop.”