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Scrubby trees hide the entryway. A sloping wooden tunnel descends to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, heart rate sensors and ventilators. And cabinets full of medical equipment, drugs and organized stacks of spare clothes. Within a break area with a washing machine and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the air above.

Medical personnel at an underground medical center observe a monitor displaying Russian kamikaze and reconnaissance UAVs in the area.

This is Ukraine’s secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, located in the eastern part of the country not far from the frontline and the city of Pokrovsk in the Donetsk region. “We are 6 metres under the ground. It’s the most secure method of delivering care to our injured soldiers. It also ensures healthcare workers safe,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating amputations, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with deadly accuracy. “90% of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

During one afternoon last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his limb. “Conflict is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He collapsed. Then the Russians dropped a second explosive on him.” He continued: “Everything in the settlement is demolished. There are UAVs all around and bodies. Our side's and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their location was by walking. Necessary provisions came by quadcopter: rations and water. Seven days after he was injured, he walked five kilometers (roughly three miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a pair of pale jeans.

Artem Dvorskiy, 28, stated a first-person view aerial device ripped a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I think I was fortunate to survive. My cousin has been lost. There are continuous detonations.” A construction worker working in a neighboring country, Filipchuk said he had returned to Ukraine and enlisted to fight days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, removed a bloody dressing and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to call his sister. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my military group. Our forces must defend our nation,” he affirmed.

Medical staff care for the wounded soldier, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently attacked hospitals, health facilities, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been killed in nearly two thousand attacks. The underground facility is constructed from multiple steel bunkers, with timber beams, soil and granular material placed above up to ground level. It is designed to resist impacts from 152mm artillery shells and even three eight-kilogram explosive devices dropped by drone.

A major industrial group, which financed the building, plans to build 20 units in total. A senior official of Ukraine’s security agency and former defence minister, Rustem Umerov, said they would be “critically essential for saving the survival of our military and assisting defenders on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had implemented since the enemy's invasion.

One of the centre’s operating theatres.

The surgeon, explained certain wounded personnel had to endure delays hours or even days before they could be transported because of the danger of air assaults. “Our facility received two severely injured casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. You have to concentrate,” he said.

Orderlies transported the soldier up the tunnel and into an ambulance. The transport was stationed under a bush. The patient and the two other military members were taken to the urban center of Dnipro for additional medical care. The underground medical team took a break. The hospital’s orange feline, the mascot, walked toward the entrance to greet the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”