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Sparse foliage hide the entrance. One sloping wooden tunnel leads down to a brightly lit reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. And cabinets stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, doctors monitor a display. It shows the movements of Russian spy drones as they zigzag in the sky above.

Hospital staff at an underground medical center observe a monitor showing enemy kamikaze and reconnaissance UAVs in the area.

This is Ukraine’s secret below-ground medical facility. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the ground. It’s the most secure method of delivering care to our injured soldiers. And it keeps medical personnel safe,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 patients a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which release grenades with lethal accuracy. “90% of our patients are from FPVs. We see few gunshot wounds. This is an age of unmanned aircraft and a new type of conflict,” the doctor said.

Major Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in the eastern region.

On one afternoon recently, three military members limped into the hospital. The most lightly injured, 28-year-old one soldier, said an first-person view drone blast had torn a minor wound in his limb. “War is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He collapsed. Then the enemy forces dropped a another explosive on him.” He continued: “Everything in the settlement is demolished. There are drones all around and bodies. Our side's and the enemy's.”

Dvorskyi said his squad endured 43 days 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 came by quadcopter: food and water. Seven days following he was hurt, he walked 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a nurse gave him fresh non-military attire: a shirt and a pair of pale jeans.

Artem Dvorskiy, 28, said a first-person view drone caused a small hole in his leg.

A different casualty, 38-year-old a serviceman, recounted a UAV explosion had left him with concussion. “I was in a dugout. It suddenly went dark. I couldn’t feel any feeling or any sound,” he explained. “I believe I was lucky to survive. My cousin has been killed. There are ongoing explosions.” A builder employed in Lithuania, he said he had returned to Ukraine and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a bed, took off a stained bandage and treated his two-day-old injury from fragments. Covered in a foil blanket, he used a cellphone to call his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my military group. Our forces has to defend our country,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the back by a piece of mortar.

Over the past years, enemy forces has consistently targeted medical centers, health facilities, obstetric units and ambulances. Per international monitors, over two hundred health workers have been fatally attacked in almost two thousand attacks. This subterranean hospital is built from multiple steel bunkers, with wooden supports, earth and granular material placed above reaching ground level. It can withstand direct hits from 152mm artillery shells and even multiple 8kg TNT charges dropped by drone.

The Ukrainian steel and mining company, which financed the construction, intends to build twenty facilities in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “vitally important for preserving the lives of our armed forces and supporting defenders on the battlefront.” The organization referred to the initiative as the “largest-scale and challenging” it had implemented since Russia’s invasion.

An example of the facility's operating theatres.

The surgeon, said some injured soldiers had to wait many hours or even multiple days before they could be transported because of the threat of air assaults. “We had a pair of severely injured patients who arrived at the early hours. I had to carry out a double amputation on one of them. His tourniquet had been applied for such an extended period there was no other option.” How did he cope with traumatic operations? “My career in medicine for 20 years. You have to concentrate,” he remarked.

Orderlies wheeled Mykolaichuk through the tunnel and into an ambulance. The transport was parked beneath a shrub. He and the other military members were taken to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s ginger cat, the mascot, walked up to the entrance to await the incoming patients. “We are open 24 hours a day,” the surgeon said. “It doesn’t stop.”