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Sparse trees conceal the entryway. A sloping wooden passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets full of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the movements of Russian spy drones as they weave in the air above.

Hospital personnel at an subterranean medical center observe a screen showing Russian kamikaze and surveillance drones in the region.

This is the nation's covert underground medical facility. The facility began operations in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are six meters below the earth. This is the safest way of delivering care to our injured military personnel. And it keeps medical personnel safe,” stated the facility's lead doctor, Major the chief surgeon.

This medical station handles thirty to forty patients a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which release grenades with lethal accuracy. “Ninety per cent 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 surgeon said.

Major the senior surgeon at the underground facility for treating injured soldiers in the eastern region.

During one day last week, 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 ripped a small hole in his limb. “Conflict is terrible. The guy beside me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a second explosive on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

The soldier said his unit spent over a month in a forest area close to the city, which enemy forces has been trying to seize for many months. The only way to get to their position was on foot. Necessary provisions arrived by quadcopter: rations and drinking water. Seven days following he was hurt, he traveled five kilometers (about 3 miles), requiring several hours, to where an military transport was able to evacuate him. At the clinic, a medic checked his physical condition. After treatment, a nurse gave him new non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone caused a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he explained. “I think I was lucky to survive. A relative has been killed. We face ongoing detonations.” A construction worker employed in a neighboring country, he noted he had come back to Ukraine and enlisted to serve shortly before the Russian leader's large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a bed, removed a bloody bandage and treated his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his sister. “A fragment of mortar 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. Subsequently, to go back to my unit. Our forces must defend our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, Russia has consistently attacked hospitals, clinics, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost 2,000 attacks. The underground facility is built from four reinforced shelters, with timber beams, soil and granular material laid on top reaching ground level. It can withstand impacts from large-caliber artillery shells and even three 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which financed the construction, intends to build 20 units in total. The head of the nation's security agency and former defence minister, the official, declared they would be “vitally essential for saving the lives of our armed forces and supporting defenders on the battlefront.” The company referred to the project as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, said certain injured personnel had to endure delays many hours or even days before they could be transported due to the danger of aerial attacks. “We had two critically ill casualties who came at 3am. I had to perform a removal of both limbs on a patient. His tourniquet had been on for so long there was no other option.” How did he cope with traumatic surgeries? “I’ve been healthcare for two decades. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The transport was stationed under a shrub. He and the other military members were transferred to the urban center of Dnipro for further treatment. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded up to the doorway to greet the next arrivals. “Our facility operates open around the clock,” the surgeon said. “The work is continuous.”