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Scrubby trees conceal the entryway. One descending timber tunnel leads down to a brightly lit reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. Plus shelves stocked of medical equipment, medications and organized stacks of extra garments. In a staff room with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Medical personnel at an subterranean medical center look at a screen showing Russian kamikaze and surveillance UAVs in the area.

Welcome to Ukraine’s covert below-ground medical facility. The facility opened in the eighth month and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure way of delivering care to our wounded military personnel. And it keeps healthcare workers protected,” stated the facility's lead doctor, Major the chief surgeon.

The stabilisation point treats 30-40 patients a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which drop grenades with deadly precision. “90% of our patients are from FPVs. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for treating injured soldiers in eastern Ukraine.

On one afternoon last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a minor wound in his limb. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians dropped a second explosive on him.” He continued: “Everything in the village is demolished. We see drones everywhere and bodies. Ours and the enemy's.”

The soldier explained his unit spent over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was on foot. Necessary provisions came by drone: rations and drinking water. A week following he was injured, he walked five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a nurse provided him with new civilian clothes: a shirt and a pair of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or any sound,” he explained. “I believe I was lucky to remain alive. A relative has been lost. We face ongoing explosions.” A builder working in Lithuania, he said he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He groaned as medical staff laid him on a medical cot, took off a stained bandage and treated his recent shrapnel wound. Covered 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. I’m OK,” he informed her. What were his plans now? “To recover. This may require a several months. After that, to return to my military group. Our forces has to protect our nation,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of mortar.

Since 2022, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in almost two thousand attacks. The underground facility is built from four steel bunkers, with timber beams, soil and sand placed above reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg TNT charges released by drone.

A major industrial group, which financed the building, plans to build twenty facilities in all. A senior official of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “critically important for preserving the survival of our military and assisting troops on the battlefront.” The organization referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

An example of the facility's operating theatres.

The surgeon, said some wounded soldiers had to wait many hours or even days before they could be evacuated because of the threat of air assaults. “Our facility received two critically ill patients who arrived at the early hours. It was necessary to perform a double amputation 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? “My career in medicine for two decades. You have to focus,” he said.

Medical assistants transported Mykolaichuk through the tunnel and into an ambulance. The transport was parked under a shrub. The patient and the other soldiers were taken to the urban center of a major city for additional medical care. The underground medical team took a break. The hospital’s ginger cat, the mascot, padded toward the doorway to await the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”