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Sparse trees hide the entryway. One sloping wooden passageway leads down to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a washing machine and kettle, doctors monitor a screen. It shows the movements of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an subterranean medical center look at a screen displaying Russian suicide and reconnaissance UAVs in the area.

This is Ukraine’s covert underground medical facility. The facility began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. It’s the most secure way of providing help to our injured soldiers. And it keeps medical personnel protected,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries requiring amputations, or severe abdominal injuries. Others can walk. Almost all are the victims of Russian FPV aerial devices, which release explosives with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. This is an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Major the senior surgeon at the subterranean installation for caring for injured troops in the eastern region.

On one day last week, three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a small hole in his leg. “War is terrible. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces released a second explosive on him.” He added: “All structures in the settlement is destroyed. We see drones all around and bodies. Ours and the enemy's.”

The soldier said his squad spent over a month in a forest area close to Pokrovsk, which Russia has been trying to seize since last year. Sole access to get to their position was on foot. All supplies came by drone: rations and water. A week after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a set of pale jeans.

The soldier, twenty-eight, said a FPV aerial device caused a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was lucky to survive. A relative has been lost. We face ongoing detonations.” A builder working in a neighboring country, he noted he had returned to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff placed him on a bed, took off a bloody bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to call his sister. “A fragment of artillery struck me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. That will take a few months. After that, to return to my unit. Our forces has to defend our nation,” he affirmed.

Doctors treat the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Over the past years, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. According to international monitors, over two hundred health workers have been killed in almost 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and granular material laid on top up to the surface. It can withstand direct hits from large-caliber projectiles and even three 8kg explosive devices released by aerial means.

A major industrial group, which financed the construction, intends to erect 20 units in all. A senior official of Ukraine’s national security council and former military leader, the official, said they would be “critically essential for preserving the lives of our military and assisting troops on the frontline.” The organization described the project as the “largest-scale and challenging” it had undertaken since the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said some injured soldiers had to endure delays hours or even multiple days before they could be transported due to the danger of aerial attacks. “We had a pair of critically ill patients who arrived at the early hours. I had to carry out a removal of both limbs 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 surgeries? “My career in healthcare for 20 years. You have to focus,” he said.

Medical assistants transported the soldier through the tunnel and into an ambulance. The vehicle was parked beneath a shrub. He and the other military members were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, walked toward the entrance to await the next arrivals. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”