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Sparse foliage conceal the entryway. A sloping timber passageway descends to a brightly lit welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus cabinets full of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a laundry appliance and hot water heater, physicians monitor a display. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Medical personnel at an underground medical center observe a screen displaying enemy kamikaze and surveillance drones in the area.

Welcome to the nation's covert below-ground medical facility. The facility began operations in the eighth month and is the second such installation, located in eastern Ukraine close to the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the ground. This is the safest way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a each day. Cases differ widely. Some have catastrophic leg injuries necessitating amputations, or serious stomach wounds. Others can move on their own. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from FPVs. We see few bullet injuries. This is an era of drones and a different kind of war,” the surgeon said.

Major the senior surgeon at the underground installation for caring for injured soldiers in eastern Ukraine.

During one afternoon last week, a group of three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a small hole in his leg. “Conflict is horrific. The guy beside me, Vasyl, was killed,” he said. “He fell down. Then the Russians released a another grenade on him.” He continued: “Everything in the village is destroyed. We see drones everywhere and bodies. Our side's and theirs.”

The soldier explained his unit endured 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their position was by walking. Necessary provisions arrived by quadcopter: food and drinking water. Seven days following he was hurt, he walked 5km (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face continuous detonations.” A construction worker employed in Lithuania, Filipchuk noted he had returned to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors laid him on a bed, removed a stained bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to ring his family member. “A piece of mortar struck me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my military group. Our forces has to protect our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, soil and sand placed above up to the surface. It can withstand direct hits from 152mm artillery shells and even multiple 8kg TNT charges released by drone.

A major industrial group, which financed the construction, plans to build twenty facilities in total. The head of the nation's security agency and former military leader, the official, said they would be “vitally important for saving the lives of our military and assisting defenders on the frontline.” The company described the initiative as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

An example of the centre’s operating theatres.

The surgeon, explained some wounded personnel had to wait hours or even days before they could be evacuated because of the danger of aerial attacks. “Our facility received two severely injured patients who arrived at 3am. I had to carry out a removal of both limbs on a patient. His tourniquet had been on for so long there was no alternative.” How did he cope with traumatic operations? “My career in healthcare for 20 years. One must focus,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an ambulance. The vehicle was stationed beneath a bush. He and the two other soldiers were taken to the city of a major city for additional medical care. The underground medical team took a break. The facility's ginger cat, the mascot, padded up to the doorway to await the incoming patients. “Our facility operates active 24 hours a day,” the surgeon said. “The work is continuous.”