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Sparse foliage hide the entrance. One descending wooden tunnel leads down to a brightly lit reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And shelves full of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an subterranean medical center observe a screen displaying enemy kamikaze and surveillance drones in the region.

This is Ukraine’s covert below-ground medical facility. The facility opened in the eighth month and is the second of its kind, situated in the eastern part of the country close to the frontline and the city of Pokrovsk in the Donetsk region. “We are six meters under the ground. It’s the most secure method of providing help to our wounded soldiers. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see few bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for treating wounded soldiers in eastern Ukraine.

On one day recently, a group of three military members limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an FPV blast had ripped a small hole in his limb. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the Russians released a another grenade on him.” He added: “Everything in the settlement is destroyed. We see UAVs everywhere and bodies. Our side's and the enemy's.”

The soldier said his unit spent over a month in a wooded zone near the city, which enemy forces has been attempting to capture since last year. Sole access to get to their location was on foot. Necessary provisions came by quadcopter: rations and water. Seven days after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse gave him new non-military attire: a T-shirt and a set of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I think I was fortunate to survive. A relative has been killed. There are ongoing detonations.” A builder employed in Lithuania, Filipchuk noted he had come back to his homeland and volunteered to serve days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a bed, removed a bloody dressing and cleaned his two-day-old shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a several months. Subsequently, to return to my military group. Our forces must defend our country,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, soil and granular material placed above reaching ground level. It can withstand direct hits from large-caliber artillery shells and even multiple 8kg explosive devices released by drone.

A major steel and mining company, which funded the building, intends to build twenty units in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “vitally important for saving the survival of our military and supporting troops on the battlefront.” The company referred to the initiative as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

One of the facility's operating theatres.

The surgeon, explained some wounded personnel had to endure delays many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had two critically ill casualties who arrived at 3am. I had to perform a double amputation on a patient. The soldier's bleeding control device had been on for so long there was no alternative.” How did he cope with traumatic operations? “My career in medicine for two decades. One must focus,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an ambulance. The transport was stationed under a shrub. He and the other military members were transferred to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The facility's orange feline, the mascot, padded toward the entrance to await the incoming patients. “Our facility operates active around the clock,” Holovashchenko said. “It doesn’t stop.”