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Sparse trees hide the entryway. One descending timber passageway leads down to a brightly lit reception area. There is a operating ward, equipped with beds, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and neat piles of extra garments. In a break area with a washing machine and hot water heater, physicians monitor a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the sky above.

Medical personnel at an underground hospital observe a monitor displaying Russian suicide and reconnaissance drones in the area.

Welcome to Ukraine’s covert underground medical facility. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of Pokrovsk in the Donetsk region. “We are 6 metres under the ground. This is the safest way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” said the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point treats 30-40 patients a day. Cases differ widely. Some have devastating leg injuries requiring surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of enemy FPV aerial devices, which release grenades with deadly accuracy. “Ninety per cent of our cases are from FPVs. We encounter few gunshot wounds. This is an age of drones and a different kind of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for injured troops in eastern Ukraine.

During one day last week, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, said an FPV explosion had torn a minor wound in his leg. “War is horrific. My comrade beside me, Vasyl, was killed,” he stated. “He fell down. Subsequently the enemy forces released a another explosive on him.” He added: “All structures in the settlement is destroyed. There are UAVs all around and bodies. Our side's and theirs.”

The soldier explained his squad endured over a month in a wooded zone near the city, which Russia has been attempting to capture since last year. Sole access to get to their location was on foot. Necessary provisions arrived by drone: rations and water. A week after he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to where an military transport was able to pick him up. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him new civilian clothes: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, 28, stated a first-person view drone caused a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I think I was fortunate to survive. A relative has been killed. There are ongoing explosions.” A construction worker employed in Lithuania, he noted he had returned to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as medical staff laid him on a bed, removed a stained dressing and treated his recent shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to return to my unit. Someone must defend our country,” he said.

Medical staff care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Over the past years, Russia has consistently targeted medical centers, health facilities, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from multiple steel bunkers, with wooden supports, soil and sand placed above reaching ground level. It is designed to resist impacts from 152mm artillery shells and even three eight-kilogram explosive devices released by drone.

A major industrial group, which financed the building, plans to build twenty facilities in total. The head of the nation's national security council and ex- defence minister, the official, declared they would be “critically essential for saving the survival of our armed forces and assisting troops on the battlefront.” The organization described the project as the “largest-scale and challenging” it had implemented since the enemy's military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain wounded personnel had to wait hours or even days before they could be evacuated due to the threat of air assaults. “We had two severely injured casualties who came at 3am. It was necessary to perform a double amputation on a patient. His bleeding control device had been on for so long there was no other option.” How did he cope with severe operations? “I’ve been healthcare for two decades. You have to concentrate,” he remarked.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The transport was parked beneath a bush. The patient and the other soldiers were transferred to the urban center of Dnipro for additional medical care. The subterranean medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked toward the entrance to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”