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Scrubby foliage hide the entrance. One descending timber passageway descends to a well-illuminated welcome zone. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. Plus shelves full of medical equipment, medications and neat piles of extra garments. In a break area with a washing machine and kettle, doctors monitor a display. It shows the movements of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground hospital observe a screen displaying Russian suicide and surveillance UAVs in the region.

Welcome to the nation's covert underground medical facility. The facility began operations in the eighth month and is the second of its kind, located in the eastern part of the country close to the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the safest method of delivering care to our injured military personnel. It also ensures medical personnel protected,” said the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 casualties a each day. Their conditions vary. Some have catastrophic limb trauma necessitating amputations, or severe abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which drop explosives with lethal precision. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. This is an era of drones and a different kind of war,” the doctor said.

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

During one afternoon recently, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had torn a minor wound in his limb. “War is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians released a another grenade on him.” He added: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

The soldier said his unit spent 43 days in a forest area close to the city, which enemy forces has been trying to seize for many months. Sole access to get to their location was by walking. Necessary provisions came by drone: rations and drinking water. Seven days following he was hurt, he traveled 5km (roughly three miles), requiring three hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him fresh civilian clothes: a T-shirt and a pair of light-colored jeans.

The soldier, 28, said a first-person view drone caused a minor injury in his leg.

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in concussion. “I was in a trench shelter. Suddenly it became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to survive. A relative has been lost. We face continuous explosions.” A builder working in Lithuania, he noted he had come back to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a bed, removed a bloody dressing and treated his recent injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his sister. “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 few months. After that, to return to my military group. Someone must protect our country,” he affirmed.

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

Since 2022, Russia has consistently attacked medical centers, clinics, obstetric units and emergency vehicles. Per international monitors, over two hundred health workers have been fatally attacked in almost two thousand assaults. The underground facility is built from four reinforced shelters, with wooden supports, soil and sand laid on top reaching ground level. It can withstand impacts from 152mm artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which financed the building, plans to erect twenty units in total. A senior official of the nation's security agency and former defence minister, the official, declared they would be “vitally essential for preserving the lives of our armed forces and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and challenging” it had undertaken since the enemy's invasion.

One of the centre’s surgical rooms.

The surgeon, explained certain injured soldiers had to endure delays many hours or even days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of critically ill patients who arrived at 3am. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been on for such an extended period there was no other option.” How did he cope with traumatic operations? “I’ve been medicine for two decades. One must concentrate,” he remarked.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The transport was stationed under a shrub. The patient and the other military members were taken to the city of Dnipro for further treatment. The underground medical team took a break. The facility's ginger cat, Vasilevs, padded toward the doorway to greet the incoming patients. “We are active around the clock,” the surgeon said. “The work is continuous.”