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Sparse foliage conceal the entryway. One descending timber passageway leads down to a brightly lit reception area. Inside lies a operating ward, equipped with gurneys, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. Within a staff room with a washing machine and kettle, physicians monitor a screen. It shows the movements of Russian surveillance UAVs as they weave in the air above.

Medical personnel at an underground hospital look at a screen showing enemy suicide and surveillance drones in the area.

Welcome to Ukraine’s secret below-ground medical facility. The facility began operations in the eighth month and is the second such installation, located in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. This is the most secure way of delivering care to our injured soldiers. And it keeps healthcare workers protected,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring amputations, or serious stomach wounds. Others can walk. The vast majority are the victims of enemy FPV drones, which drop explosives with lethal accuracy. “90% of our patients are from first-person view drones. We see minimal bullet injuries. It’s an age of unmanned aircraft and a different kind of war,” the surgeon said.

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

On one afternoon last week, three military members limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an FPV explosion had torn a small hole in his leg. “Conflict is horrific. The guy beside me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second explosive on him.” He continued: “Everything in the village is demolished. There are drones all around and bodies. Ours and the enemy's.”

The soldier explained his unit endured 43 days in a forest area near Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to reach their position was by walking. Necessary provisions arrived by drone: rations and water. A week after he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse gave him fresh non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, 28, stated a first-person view drone caused a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. There are continuous detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to his homeland and volunteered to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He groaned as doctors laid him on a medical cot, removed a stained bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “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 few months. After that, to go back to my unit. Someone has to protect our nation,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the dorsal area by a piece of artillery shell.

Over the past years, Russia has consistently targeted hospitals, clinics, maternity wards and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in nearly 2,000 assaults. The underground facility is constructed from multiple steel bunkers, with timber beams, soil and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg TNT charges dropped by aerial means.

A major steel and mining company, which financed the building, plans to erect 20 units in all. The head of the nation's security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for preserving the lives of our military and supporting defenders on the frontline.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented after the enemy's invasion.

One of the centre’s operating theatres.

The surgeon, explained some injured soldiers had to wait many hours or even multiple days before they could be transported due to the threat of air assaults. “Our facility received a pair of severely injured casualties who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. The soldier's bleeding control device had been on for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked under a shrub. He and the other military members were transferred to the city of a major city for further treatment. The subterranean medical team paused for rest. The hospital’s ginger cat, the mascot, padded toward the doorway to greet the incoming patients. “We are open around the clock,” the surgeon said. “It doesn’t stop.”