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Scrubby trees hide the entrance. One descending wooden tunnel descends to a brightly lit reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. Plus cabinets stocked of medical equipment, medications and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a display. It shows the movements of enemy surveillance UAVs as they weave in the sky above.

Medical personnel at an underground hospital observe a monitor displaying Russian kamikaze and reconnaissance drones in the region.

Welcome to the nation's secret below-ground hospital. The facility began operations in August and is the second such installation, located in eastern Ukraine close to the frontline and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters under the earth. It’s the most secure method of delivering care to our injured soldiers. It also ensures medical personnel protected,” said the facility's surgeon, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. The vast majority are the victims of enemy FPV aerial devices, which drop explosives with lethal precision. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. It’s an age of drones and a new type of war,” the surgeon said.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in eastern Ukraine.

On one afternoon recently, a group of three soldiers walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, said an first-person view drone blast had ripped a minor wound in his limb. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces dropped a another grenade on him.” He continued: “Everything in the village is demolished. There are drones all around and bodies. Ours and theirs.”

The soldier said his squad spent 43 days in a forest area near Pokrovsk, which Russia has been trying to seize for many months. Sole access to get to their location was by walking. Necessary provisions came by drone: food and water. A week after he was hurt, he traveled five kilometers (roughly three miles), taking several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, 28, said a first-person view drone ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was lucky to survive. My cousin has been lost. We face ongoing explosions.” A builder working in Lithuania, he noted he had come back to Ukraine and volunteered to serve days before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the back. He groaned as medical staff laid him on a medical cot, took off a stained bandage and treated his recent injury from fragments. Covered in a foil blanket, he used a cellphone to ring his sister. “A piece of artillery hit me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. That will take a several months. After that, to return to my military group. Our forces has to defend our nation,” he said.

Doctors treat the wounded soldier, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been fatally attacked in almost 2,000 attacks. The underground facility is built from multiple reinforced shelters, with timber beams, soil and sand laid on top reaching the surface. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which funded the building, intends to erect 20 units in all. The head of the nation's national security council and ex- defence minister, the official, said they would be “vitally important for saving the survival of our armed forces and assisting defenders on the battlefront.” The company described the initiative as the “most ambitious and demanding” it had undertaken since Russia’s military offensive.

One of the facility's operating theatres.

The surgeon, said certain injured soldiers had to wait many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had a pair of severely injured patients who arrived at 3am. It was necessary to carry out a double amputation on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” How did he cope with severe operations? “My career in healthcare for 20 years. One must concentrate,” he said.

Medical assistants transported Mykolaichuk up the tunnel and into an ambulance. The transport was parked under a shrub. He and the other soldiers were taken to the city of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked toward the doorway to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”