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Sparse foliage conceal the entrance. A descending wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and breathing machines. Plus shelves stocked of medical equipment, drugs and organized stacks of extra garments. In a break area with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an subterranean hospital look at a monitor showing Russian kamikaze and reconnaissance UAVs in the area.

Welcome to the nation's covert underground medical facility. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the ground. This is the safest method of delivering care to our wounded soldiers. And it keeps medical personnel protected,” said the facility's surgeon, Maj the chief surgeon.

This medical station handles 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from devastating leg injuries necessitating amputations, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We encounter few bullet injuries. It’s an era of drones and a different kind of conflict,” the doctor explained.

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

On one day recently, a group of three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV blast had torn a small hole in his limb. “Conflict is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians released a another grenade on him.” He added: “All structures in the settlement is demolished. There are UAVs everywhere and bodies. Our side's and the enemy's.”

The soldier said his unit endured over a month in a forest area near Pokrovsk, which Russia has been trying to seize for many months. Sole access to get to their location was by walking. All supplies arrived by drone: rations and water. Seven days following he was injured, he walked 5km (roughly three miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. Following care, a medical attendant provided him with new non-military attire: a shirt and a pair of pale jeans.

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

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I believe I was lucky to survive. A relative has been lost. There are continuous detonations.” A builder employed in Lithuania, Filipchuk said he had come back to his homeland 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 back. He expressed pain as doctors placed him on a medical cot, removed a bloody dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to call his sister. “A fragment of artillery hit me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. That will take a several months. After that, to return to my military group. Our forces must protect our country,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Over the past years, enemy forces has repeatedly targeted hospitals, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been fatally attacked in nearly two thousand assaults. The underground facility is built from four steel bunkers, with timber beams, soil and sand placed above up to ground level. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which financed the building, intends to build 20 units in total. A senior official of Ukraine’s national security council and ex- military leader, the official, said they would be “vitally important for preserving the survival of our armed forces and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and demanding” it had implemented after the enemy's military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained some wounded soldiers had to wait hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had two critically ill casualties who came at 3am. I had to perform a removal of both limbs on a patient. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with traumatic operations? “I’ve been medicine for two decades. You have to concentrate,” he said.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the two other military members were taken to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The hospital’s orange feline, Vasilevs, padded up to the doorway to await the incoming patients. “Our facility operates active 24 hours a day,” Holovashchenko said. “The work is continuous.”