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Scrubby foliage conceal the entryway. A descending wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. And shelves full of medical equipment, drugs and organized stacks of spare clothes. In a break area with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the movements of Russian spy drones as they weave in the air above.

Medical staff at an underground medical center look at a screen displaying Russian suicide and surveillance UAVs in the area.

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 a key location in the Donetsk region. “Our facility sits 6 metres below the ground. It’s the most secure way of providing help to our wounded soldiers. And it keeps healthcare workers protected,” stated the facility's lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of Russian FPV aerial devices, which release grenades with deadly precision. “90% of our cases are from FPVs. We encounter minimal gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj the senior surgeon at the subterranean installation for caring for wounded troops in the eastern region.

On one afternoon last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had ripped a minor wound in his leg. “Conflict is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He added: “Everything in the village is demolished. We see drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad spent 43 days in a forest area near the city, which enemy forces has been trying to seize since last year. The only way to get to their position was by walking. All supplies came by quadcopter: food and drinking water. A week following he was hurt, he traveled 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his vital signs. After treatment, a medical attendant provided him with new non-military attire: a shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, stated a FPV aerial device ripped a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to remain alive. A relative has been lost. There are continuous detonations.” A builder employed in Lithuania, he said he had returned to Ukraine and enlisted to fight days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a bed, took off a stained dressing and cleaned his two-day-old injury from fragments. Covered in a foil blanket, he used a cellphone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. That will take a few months. Subsequently, to go back to my military group. Someone has to protect our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Over the past years, enemy forces has repeatedly targeted medical centers, health facilities, obstetric units and emergency vehicles. According to international monitors, over two hundred health workers have been killed in nearly 2,000 attacks. The underground facility is constructed from four reinforced shelters, with wooden supports, earth and sand laid on top reaching the surface. It is designed to resist direct hits from 152mm projectiles and even three eight-kilogram explosive devices dropped by drone.

The Ukrainian steel and mining company, which funded the construction, intends to build 20 facilities in total. The head of the nation's security agency and ex- military leader, Rustem Umerov, said they would be “vitally important for preserving the lives of our armed forces and assisting defenders on the frontline.” The company described the project as the “largest-scale and challenging” it had implemented since Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, said certain injured soldiers had to endure delays many hours or even days before they could be transported due to the danger of aerial attacks. “We had two critically ill casualties who came at 3am. It was necessary to perform a double amputation on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” What is his method with severe surgeries? “I’ve been medicine for two decades. One must focus,” he said.

Medical assistants transported the soldier through the passage and into an emergency vehicle. The transport was parked beneath a bush. He and the two other soldiers were transferred to the city of Dnipro for further treatment. The underground medical team paused for rest. The facility's orange feline, the mascot, padded up to the doorway to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko said. “It doesn’t stop.”