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Sparse trees conceal the entryway. A sloping wooden tunnel descends to a brightly lit welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a washing machine and hot water heater, physicians monitor a screen. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an underground medical center observe a monitor showing enemy suicide and surveillance UAVs in the area.

Welcome to Ukraine’s secret below-ground medical facility. The facility began operations in August and is the second such installation, situated in the eastern part of the country not far from the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the safest way of delivering care to our wounded military personnel. And it keeps medical personnel protected,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) aerial devices, which drop explosives with lethal precision. “Ninety per cent of our cases are from FPVs. We encounter minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the doctor said.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded soldiers in the eastern region.

During one day recently, 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 blast had torn a small hole in his limb. “War is horrific. My comrade next to me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the Russians released a second grenade on him.” He continued: “All structures in the settlement is demolished. We see drones everywhere and casualties. Our side's and the enemy's.”

The soldier explained his unit endured over a month in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. The only way to get to their position was on foot. All supplies arrived by drone: food and water. Seven days following he was hurt, he walked five kilometers (roughly three miles), requiring several 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 provided him with fresh civilian clothes: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device ripped a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a dugout. Suddenly it became black. I couldn’t feel anything or hear anything,” he explained. “I think I was lucky to remain alive. My cousin has been lost. There are continuous detonations.” A builder employed in a neighboring country, he noted he had come back to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a bloody dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his family member. “A piece of mortar hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. That will take a few months. Subsequently, to return to my unit. Someone has to defend our country,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a piece of mortar.

Since 2022, Russia has consistently attacked medical centers, health facilities, obstetric units and emergency vehicles. Per human rights groups, 261 health workers have been killed in nearly 2,000 attacks. This subterranean hospital is built from four steel bunkers, with timber beams, soil and granular material placed above reaching the surface. It is designed to resist impacts from 152mm projectiles and even multiple eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which funded the building, plans to build twenty facilities in all. A senior official of the nation's national security council and former defence minister, Rustem Umerov, declared they would be “vitally essential for preserving the survival of our armed forces and supporting troops on the frontline.” The company described the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, said some wounded soldiers had to wait many hours or even days before they could be transported due to the threat of aerial attacks. “Our facility received two severely injured casualties who arrived at 3am. It was necessary to perform a removal of both limbs on a patient. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with traumatic operations? “I’ve been healthcare for two decades. One must concentrate,” he remarked.

Orderlies wheeled the soldier up the tunnel and into an ambulance. The vehicle was parked under a bush. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The underground hospital staff took a break. The facility's orange feline, Vasilevs, walked toward the entrance to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”