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Scrubby trees hide the entrance. One sloping wooden passageway descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. And shelves full of healthcare supplies, medications and organized stacks of extra garments. Within a staff room with a washing machine and kettle, physicians keep an eye on a display. It shows the movements of enemy spy drones as they zigzag in the sky above.

Medical staff at an underground medical center observe a screen showing enemy suicide and reconnaissance UAVs in the area.

This is the nation's covert below-ground medical facility. This center opened in August and is the second of its kind, located in the eastern part of the country not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the earth. This is the safest method of delivering care to our injured soldiers. It also ensures medical personnel protected,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 patients a day. Their conditions vary. Some have catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which release explosives with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an age of drones and a different kind of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for caring for wounded soldiers in the eastern region.

During one day recently, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his leg. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He continued: “All structures in the village is destroyed. There are drones everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his unit spent 43 days in a wooded zone near the city, which enemy forces has been attempting to capture since last year. The only way to reach their position was on foot. All supplies came by quadcopter: food and drinking water. A week after he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to 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 shirt and a set of pale denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to remain alive. My cousin has been lost. We face continuous explosions.” A construction worker employed in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to fight shortly 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 doctors laid him on a bed, took off a stained bandage and cleaned his recent injury from fragments. Covered in a thermal sheet, he used a mobile phone to call his sister. “A piece of mortar struck me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to go back to my unit. Someone must defend our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, Russia has repeatedly attacked medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, 261 health workers have been killed in almost 2,000 assaults. This subterranean hospital is built from four steel bunkers, with wooden supports, soil and sand placed above reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg TNT charges released by aerial means.

A major industrial group, which financed the construction, plans to erect 20 units in total. The head of the nation's national security council and former defence minister, the official, declared they would be “critically essential for saving the survival of our armed forces and supporting troops on the frontline.” The company described the project as the “most ambitious and demanding” it had implemented since Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, said some injured soldiers had to endure delays hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received a pair of severely injured casualties who arrived at 3am. I had to perform a double amputation on one of them. His tourniquet had been applied for so long there was no other option.” What is his method with traumatic surgeries? “I’ve been medicine for two decades. One must concentrate,” he said.

Medical assistants wheeled the soldier through the tunnel and into an emergency vehicle. The transport was stationed beneath a bush. He and the other military members were taken to the urban center of a major city for additional medical care. The underground medical team paused for rest. The hospital’s ginger cat, the mascot, walked toward the doorway to await the incoming patients. “We are active 24 hours a day,” the surgeon said. “The work is continuous.”