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Sparse trees hide the entrance. One sloping wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, equipped with beds, cardiac monitors and ventilators. And cabinets full of medical equipment, drugs and neat piles of spare clothes. Within a staff room with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the air above.

Medical staff at an subterranean medical center observe a screen showing enemy kamikaze and reconnaissance drones in the area.

This is the nation's covert below-ground hospital. The facility opened in the eighth month and is the second of its kind, situated in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. It’s the safest way of providing help to our injured soldiers. And it keeps healthcare workers protected,” stated the facility's lead doctor, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or serious abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy FPV drones, which release explosives with deadly accuracy. “90% of our patients are from FPVs. We encounter few bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the doctor said.

Major the senior surgeon at the underground facility for treating injured troops in eastern Ukraine.

On one day recently, three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces dropped a second explosive 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 explained his squad spent over a month in a wooded zone close to the city, which enemy forces has been attempting to capture since last year. The only way to get to their position was on foot. Necessary provisions came by drone: rations 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 evacuate him. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him fresh civilian clothes: a T-shirt and a set of light-colored denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a trench shelter. It suddenly became black. I lost sensation anything or hear anything,” he said. “I think I was lucky to survive. My cousin has been lost. We face ongoing explosions.” A builder working in a neighboring country, Filipchuk noted he had come back to his homeland and volunteered to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff laid him on a medical cot, took off a stained bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of artillery struck me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a few months. After that, to go back to my unit. Our forces must defend our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the back by a piece of artillery shell.

Over the past years, enemy forces has consistently attacked hospitals, health facilities, maternity wards and ambulances. Per international monitors, 261 health workers have been killed in almost 2,000 attacks. The underground facility is built from four steel bunkers, with wooden supports, earth and sand laid on top reaching ground level. It can withstand impacts from large-caliber artillery shells and even multiple eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which financed the construction, intends to build twenty units in all. A senior official of Ukraine’s security agency and ex- defence minister, the official, said they would be “vitally important for preserving the lives of our military and supporting defenders on the frontline.” The organization described the project as the “most ambitious and challenging” it had undertaken after the enemy's invasion.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain injured soldiers had to endure delays hours or even days before they could be evacuated because of the danger of aerial attacks. “We had a pair of critically ill patients who arrived at the early hours. It was necessary to perform a double amputation on one of them. His bleeding control device had been on for so long there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for 20 years. You have to focus,” he said.

Medical assistants transported Mykolaichuk through the tunnel and into an ambulance. The transport was parked under a shrub. He and the two other military members were transferred to the urban center of a major city for additional medical care. The underground hospital staff paused for rest. The facility's ginger cat, Vasilevs, padded up to the entrance to greet the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”