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Sparse trees hide the entrance. One sloping wooden passageway leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. Plus cabinets full of medical equipment, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the movements of Russian spy drones as they weave in the air above.

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

Welcome to Ukraine’s covert underground medical facility. The facility opened in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres below the earth. It’s the safest way of delivering care to our wounded military personnel. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats thirty to forty patients a day. Their conditions vary. Some have catastrophic limb trauma requiring amputations, or severe stomach wounds. Others can move on their own. Almost all are the victims of enemy FPV drones, which release explosives with deadly precision. “Ninety per cent of our cases are from first-person view drones. We see minimal bullet injuries. It’s an era of drones and a new type of war,” the doctor said.

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

During one day last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a small hole in his limb. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he stated. “He collapsed. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the village is destroyed. There are drones all around and bodies. Our side's and theirs.”

The soldier explained his unit endured 43 days in a wooded zone near Pokrovsk, which Russia has been attempting to capture for many months. The only way to get to their position was by walking. Necessary provisions arrived by drone: food and water. Seven days following he was injured, he walked 5km (about 3 miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a set of pale denim trousers.

The soldier, twenty-eight, stated a FPV aerial device caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or any sound,” he said. “I believe I was lucky to survive. A relative has been lost. There are continuous explosions.” A builder employed in Lithuania, he noted he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as doctors laid him on a bed, took off a bloody bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his sister. “A piece of artillery struck me. It was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to return to my military group. Someone must protect our nation,” he affirmed.

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

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been killed in nearly two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and granular material placed above reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg explosive devices dropped by aerial means.

A major steel and mining company, which funded the building, intends to erect twenty units in total. The head of the nation's national security council and ex- defence minister, the official, declared they would be “critically important for saving the lives of our military and assisting troops on the battlefront.” The organization referred to the project as the “most ambitious and challenging” it had implemented after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said certain injured soldiers had to endure delays hours or even multiple days before they could be evacuated because of the threat of air assaults. “Our facility received a pair of severely injured patients who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. His tourniquet had been applied for so long there was no other option.” How did he cope with traumatic operations? “My career in medicine for two decades. One must concentrate,” he said.

Orderlies wheeled the soldier through the passage and into an ambulance. The transport was parked under a shrub. He and the other military members were taken to the urban center of a major city for further treatment. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the doorway to greet the incoming patients. “Our facility operates active 24 hours a day,” the surgeon stated. “It doesn’t stop.”