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Scrubby trees hide the entryway. One descending wooden tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. Plus shelves stocked of medical equipment, medications and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, doctors monitor a display. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Hospital staff at an underground hospital observe a monitor displaying enemy suicide and surveillance UAVs in the region.

Welcome to the nation's covert below-ground medical facility. The facility opened in August and is the second of its kind, located in eastern Ukraine close to the frontline and the city of a key location in the Donetsk region. “We are 6 metres below the ground. This is the most secure method of providing help to our injured soldiers. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles 30-40 patients a day. Their conditions vary. Some have devastating leg injuries requiring surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the victims of Russian FPV aerial devices, which drop grenades with deadly accuracy. “Ninety per cent of our patients are from FPVs. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in the eastern region.

On one day last week, three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the settlement is destroyed. There are drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit spent over a month in a forest area close to Pokrovsk, which Russia has been trying to seize since last year. The only way to reach their location was on foot. Necessary provisions came by quadcopter: rations and water. Seven days following he was hurt, he walked 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a set of pale jeans.

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

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I think I was fortunate to survive. My cousin has been lost. There are continuous detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve days before the Russian leader's large-scale attack 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, took off a stained dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he used a cellphone to ring his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a several months. After that, to go back to my military group. Our forces must defend our country,” 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, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred medical personnel have been fatally attacked in nearly two thousand attacks. The underground facility is built from multiple reinforced shelters, with wooden supports, earth and granular material laid on top reaching ground level. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges released by drone.

The Ukrainian industrial group, which financed the building, plans to build twenty facilities in total. A senior official of the nation's security agency and former defence minister, the official, declared they would be “critically essential for saving the lives of our military and supporting troops on the frontline.” The company described the project as the “largest-scale and demanding” it had undertaken since Russia’s military offensive.

One of the facility's operating theatres.

The surgeon, said some injured personnel had to endure delays many hours or even days before they could be evacuated because of the threat of aerial attacks. “Our facility received two critically ill 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 on for such an extended period there was no other option.” What is his method with traumatic operations? “My career in medicine for two decades. One must focus,” he said.

Orderlies transported the soldier through the passage and into an ambulance. The transport was stationed under a bush. He and the other soldiers were transferred to the urban center of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, Vasilevs, walked up to the doorway to greet the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”