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Sparse foliage hide the entryway. One sloping wooden passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and breathing machines. And shelves stocked of medical equipment, drugs and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, doctors keep an eye on a display. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance drones in the region.

Welcome to the nation's covert below-ground medical facility. This center began operations in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “We are 6 metres under the ground. It’s the safest method of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the facility's surgeon, Maj the chief surgeon.

This medical station handles 30-40 patients a each day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or severe abdominal injuries. Some patients can move on their own. The vast majority are the victims of Russian FPV drones, which drop explosives with lethal accuracy. “90% of our patients are from FPVs. We see few gunshot wounds. This is an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for caring for injured soldiers in the eastern region.

On one day last week, three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a minor wound in his limb. “Conflict is terrible. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a second explosive on him.” He added: “Everything in the village is destroyed. There are drones everywhere and casualties. Our side's and theirs.”

The soldier said his unit endured 43 days in a forest area near Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to get to their position was by walking. All supplies arrived by quadcopter: food and water. A week after he was hurt, he traveled 5km (roughly three miles), requiring several hours, to where an military transport was able to pick him up. Upon arrival, a medical staff checked his physical condition. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view drone ripped a small hole in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly became black. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to survive. A relative has been killed. We face ongoing explosions.” A construction worker working in a neighboring country, Filipchuk said he had returned to Ukraine and enlisted to serve shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a medical cot, removed a stained dressing and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A piece of mortar struck me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my military group. Someone must defend our country,” he said.

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

Over the past years, Russia has consistently attacked hospitals, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in almost two thousand assaults. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material placed above up to ground level. It can withstand direct hits from 152mm projectiles and even three 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the building, plans to build twenty facilities in all. A senior official of the nation's national security council and ex- defence minister, the official, declared they would be “vitally important for saving the lives of our military and supporting troops on the frontline.” The company described the initiative as the “largest-scale and demanding” it had implemented since Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, said some wounded personnel had to wait hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had a pair of critically ill patients who came at 3am. It was necessary to carry out a removal of both limbs on a patient. The soldier's tourniquet had been on for so long there was no other option.” How did he cope with severe operations? “My career in medicine for 20 years. One must concentrate,” he said.

Orderlies transported Mykolaichuk through the tunnel and into an ambulance. The transport was parked beneath a shrub. He and the two other military members were taken to the urban center of Dnipro for additional medical care. The subterranean hospital staff took a break. The facility's ginger cat, Vasilevs, padded up to the entrance to greet the next arrivals. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”