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Scrubby foliage conceal the entryway. A sloping timber passageway descends to a brightly lit reception area. There is a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a break area with a washing machine and hot water heater, physicians monitor a display. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Medical staff at an underground medical center look at a screen displaying enemy suicide and reconnaissance drones in the region.

Welcome to the nation's secret underground medical facility. This center opened in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres below the earth. This is the most secure way of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which release grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. It’s an age of drones and a different kind of war,” the doctor explained.

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

On one afternoon last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a minor wound in his limb. “Conflict is terrible. The guy next to me, Vasyl, was killed,” he stated. “He collapsed. Then the Russians released a another explosive on him.” He added: “Everything in the village is demolished. There are UAVs everywhere and bodies. Ours and the enemy's.”

The soldier explained his squad spent 43 days in a forest area close to Pokrovsk, which Russia has been attempting to capture since last year. The only way to get to their position was by walking. All supplies came by drone: food and water. Seven days after he was hurt, he walked five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale denim trousers.

The soldier, twenty-eight, said a FPV aerial device caused a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “I was in a dugout. It suddenly became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been killed. We face ongoing explosions.” A builder working in Lithuania, Filipchuk noted he had returned to Ukraine and volunteered to fight 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 medical staff placed him on a bed, removed a stained bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to ring his family member. “A piece of mortar hit me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. After that, to return to my unit. Someone must defend our nation,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has repeatedly targeted medical centers, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been killed in almost two thousand assaults. The underground facility is built from four reinforced shelters, with timber beams, earth and sand laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg explosive devices released by aerial means.

The Ukrainian industrial group, which funded the construction, intends to build twenty facilities in all. The head of the nation's security agency and ex- military leader, Rustem Umerov, declared they would be “critically important for preserving the survival of our armed forces and assisting troops on the frontline.” The organization referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained some injured personnel had to wait many hours or even days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill patients who arrived at the early hours. I had to carry out a removal of both limbs on one of them. His bleeding control device had been on for so long there was no other option.” What is his method with traumatic operations? “My career in medicine for two decades. You have to focus,” he remarked.

Orderlies wheeled the soldier up the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean medical team paused for rest. The hospital’s ginger cat, Vasilevs, padded up to the entrance to greet the next arrivals. “Our facility operates open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”