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Sparse trees conceal the entryway. One sloping wooden tunnel leads down to a brightly lit reception area. There is a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. In a staff room with a laundry appliance and kettle, physicians monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Medical staff at an underground medical center observe a screen displaying enemy kamikaze and surveillance drones in the area.

This is the nation's secret below-ground hospital. This center opened in the eighth month and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the earth. It’s the safest method of delivering care to our wounded military personnel. And it keeps medical personnel protected,” said the clinic’s surgeon, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries necessitating amputations, or serious stomach wounds. Some patients can move on their own. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from FPVs. We see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Major the senior surgeon at the subterranean installation for treating injured troops in the eastern region.

During one day recently, three soldiers limped into the hospital. 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 horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is demolished. We see drones all around and casualties. Our side's and the enemy's.”

The soldier said his unit spent 43 days in a forest area near Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their location was by walking. Necessary provisions came by drone: food and water. A week following he was hurt, he walked 5km (about 3 miles), taking three hours, to where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale denim trousers.

Artem Dvorskiy, 28, said a first-person view drone caused a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, said a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he said. “I believe I was fortunate to survive. My cousin has been lost. We face ongoing detonations.” A builder working in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to serve days before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as medical staff placed him on a medical cot, removed a bloody dressing and cleaned his recent injury from fragments. Covered in a foil blanket, he borrowed a cellphone to call his sister. “A fragment of mortar struck me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to go back to my military group. Our forces must defend 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 medical centers, clinics, obstetric units and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in nearly 2,000 assaults. The underground facility is built from four reinforced shelters, with wooden supports, soil and sand placed above reaching the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple 8kg explosive devices dropped by drone.

The Ukrainian industrial group, which funded the building, plans to erect twenty facilities in all. The head of Ukraine’s security agency and former military leader, the official, said they would be “critically essential for preserving the survival of our military and assisting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained certain wounded personnel had to endure delays hours or even days before they could be transported due to the danger of air assaults. “Our facility received two severely injured casualties who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. The soldier's bleeding control device had been on for so long there was no alternative.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. You have to concentrate,” he remarked.

Orderlies wheeled the soldier up the passage and into an ambulance. The vehicle was stationed beneath a shrub. He and the two other soldiers were transferred to the city of Dnipro for further treatment. The underground medical team took a break. The hospital’s orange feline, the mascot, padded up to the entrance to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko stated. “It doesn’t stop.”