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Scrubby foliage hide the entryway. A descending wooden tunnel leads down to a brightly lit reception area. There is a operating ward, outfitted with gurneys, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a break area with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

Medical personnel at an subterranean hospital observe a screen showing Russian kamikaze and surveillance drones in the region.

Welcome to Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine close to the frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters under the ground. This is the safest way of delivering care to our injured military personnel. It also ensures medical personnel safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of enemy FPV aerial devices, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an age of drones and a new type of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground 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 least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a minor wound in his limb. “War is terrible. The guy next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians released a another grenade on him.” He added: “Everything in the village is destroyed. We see drones all around and casualties. Ours and the enemy's.”

The soldier explained his unit spent over a month in a wooded zone close to Pokrovsk, which Russia has been attempting to capture for many months. The only way to reach their position was on foot. All supplies came by quadcopter: rations and drinking water. A week following he was injured, he walked 5km (roughly three miles), taking three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff checked his physical condition. Following care, a medical attendant gave him fresh non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, said a first-person view drone ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I think I was fortunate to survive. My cousin has been killed. There are ongoing detonations.” A construction worker working in Lithuania, Filipchuk noted he had returned to Ukraine and volunteered to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors placed him on a bed, removed a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to call his sister. “A fragment of artillery hit me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a few months. After that, to go back to my military group. Someone must defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a fragment of artillery shell.

Since 2022, Russia has consistently attacked hospitals, health facilities, maternity wards and ambulances. Per international monitors, over two hundred medical personnel have been killed in nearly two thousand attacks. The underground facility is built from four reinforced shelters, with timber beams, soil and sand laid on top up to the surface. It is designed to resist impacts from 152mm projectiles and even three eight-kilogram TNT charges dropped by drone.

The Ukrainian steel and mining company, which funded the building, intends to build 20 facilities in total. The head of Ukraine’s national security council and former military leader, Rustem Umerov, declared they would be “critically important for saving the survival of our armed forces and assisting troops on the frontline.” The company referred to the initiative as the “most ambitious and challenging” it had undertaken after the enemy's invasion.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain injured personnel had to endure delays hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received two severely injured patients who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for so long there was no other option.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Orderlies wheeled the soldier up the tunnel and into an ambulance. The transport was parked under a bush. He and the other military members were transferred to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The facility's orange feline, Vasilevs, walked toward the doorway to greet the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko said. “The work is continuous.”