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Scrubby trees hide the entrance. One sloping wooden tunnel descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves stocked of healthcare supplies, drugs and neat piles of extra garments. In a break area with a laundry appliance and kettle, doctors keep an eye on a screen. It shows the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Hospital staff at an subterranean medical center observe a screen showing enemy suicide and surveillance UAVs in the region.

This is Ukraine’s secret below-ground medical facility. The facility began operations in August and is the second such installation, located in eastern Ukraine close to the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits six meters under the ground. This is the most secure method of delivering care to our injured soldiers. And it keeps healthcare workers protected,” said the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries necessitating amputations, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of Russian FPV drones, which release grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for treating wounded troops in the eastern region.

During one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had ripped a minor wound in his leg. “War is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces dropped a another grenade on him.” He continued: “Everything in the village is demolished. We see drones all around and bodies. Ours and theirs.”

The soldier explained his squad endured 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was on foot. Necessary provisions came by drone: food and drinking water. A week following he was hurt, he traveled 5km (about 3 miles), taking several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him new non-military attire: a shirt and a pair of pale jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device caused a minor injury in his leg.

Another patient, thirty-eight-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I lost sensation anything or hear anything,” he explained. “I believe I was lucky to remain alive. A relative has been lost. We face continuous explosions.” A builder employed in a neighboring country, he said he had returned to Ukraine and volunteered to fight days before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff laid him on a bed, removed a bloody dressing and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone 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. This may require a several months. Subsequently, to return to my military group. Someone must protect our country,” he affirmed.

Doctors care for Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Over the past years, Russia has consistently targeted medical centers, clinics, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been fatally attacked in nearly 2,000 assaults. The underground facility is constructed from multiple steel bunkers, with wooden supports, soil and sand laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg TNT charges released by aerial means.

A major steel and mining company, which funded the construction, intends to erect 20 facilities in total. The head of Ukraine’s national security council and former defence minister, the official, said they would be “critically important for preserving the lives of our military and supporting defenders on the frontline.” The organization described the project as the “most ambitious and demanding” it had undertaken since Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained certain injured soldiers had to endure delays many hours or even days before they could be evacuated because of the danger of air assaults. “Our facility received two severely injured casualties who came at the early hours. I had to carry out a double amputation on one of them. His bleeding control device had been on for such an extended period there was no alternative.” What is his method with severe surgeries? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was stationed beneath a bush. He and the two other military members were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded toward the doorway to await the incoming patients. “Our facility operates active around the clock,” the surgeon stated. “The work is continuous.”