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Scrubby trees conceal the entrance. A descending timber passageway descends to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and breathing machines. And shelves full of medical equipment, medications and organized stacks of extra garments. In a staff room with a laundry appliance and kettle, doctors keep an eye on a display. It shows the flight patterns of Russian spy drones as they zigzag in the air above.

Medical personnel at an subterranean medical center observe a monitor showing Russian suicide and surveillance drones in the region.

Welcome to the nation's secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, situated in eastern Ukraine not far from the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the ground. This is the safest method of delivering care to our wounded military personnel. It also ensures medical personnel protected,” stated the facility's lead doctor, Major the chief surgeon.

This medical station handles 30-40 casualties a each day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or severe stomach wounds. Others can walk. Almost all are the victims of Russian FPV drones, which drop grenades with lethal accuracy. “90% of our patients are from first-person view drones. We see minimal gunshot wounds. This is an era of drones and a new type of conflict,” the doctor said.

Major the senior surgeon at the subterranean facility for caring for injured soldiers in the eastern region.

During one afternoon last week, three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a small hole in his limb. “War is terrible. The guy next to me, Vasyl, was killed,” he stated. “He fell down. Then the Russians released a second grenade on him.” He continued: “Everything in the village is demolished. There are drones all around and bodies. Our side's and theirs.”

Dvorskyi said his unit endured over a month in a forest area close to the city, which enemy forces has been attempting to capture since last year. The only way to reach their location was on foot. All supplies arrived by drone: food and drinking water. A week after he was injured, he traveled five kilometers (roughly three miles), taking three hours, to where an military transport was able to pick him up. At the clinic, a medic checked his vital signs. After treatment, a nurse gave him new non-military attire: a T-shirt and a pair of pale denim trousers.

The soldier, twenty-eight, stated a FPV aerial device caused a small hole in his lower limb.

A different casualty, 38-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been killed. There are continuous detonations.” A builder working in Lithuania, Filipchuk noted he had returned to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff laid him on a bed, removed a stained dressing and treated his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to call his family member. “A fragment of artillery hit me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. After that, to return to my military group. Someone must protect our country,” he said.

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

Since 2022, Russia has consistently attacked hospitals, health facilities, obstetric units and emergency vehicles. Per human rights groups, over two hundred medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is built from four steel bunkers, with wooden supports, earth and sand laid on top up to the surface. It is designed to resist direct hits from 152mm artillery shells and even three 8kg TNT charges dropped by aerial means.

A major steel and mining company, which funded the construction, intends to build twenty units in total. The head of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our armed forces and assisting troops on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

An example of the centre’s surgical rooms.

The surgeon, said some wounded soldiers had to endure delays many hours or even days before they could be evacuated because of the threat of air assaults. “Our facility received a pair of critically ill casualties who came at the early hours. It was necessary to perform a double amputation on a patient. His bleeding control device had been applied for such an extended period there was no other option.” How did he cope with traumatic operations? “My career in healthcare for two decades. One must concentrate,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was parked beneath a shrub. He and the other military members were taken to the city of Dnipro for further treatment. The underground hospital staff took a break. The facility's ginger cat, Vasilevs, padded up to the entrance to await the incoming patients. “We are open around the clock,” Holovashchenko stated. “The work is continuous.”