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Scrubby trees hide the entryway. One sloping timber tunnel leads down to a well-illuminated welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and ventilators. And shelves full of healthcare supplies, drugs and neat piles of extra garments. In a break area with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the sky above.

Medical staff at an underground medical center observe a screen displaying Russian suicide and reconnaissance UAVs in the region.

This is the nation's secret underground medical facility. The facility began operations in August and is the second of its kind, situated in the eastern part of the country not far from the combat zone and the urban area of a key location in the Donetsk region. “We are six meters under the earth. It’s the most secure method of providing help to our wounded military personnel. It also ensures medical personnel protected,” stated the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) drones, which release explosives with lethal precision. “90% of our cases are from FPVs. We see minimal bullet injuries. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for treating injured troops in eastern Ukraine.

During one afternoon last week, three military members limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his leg. “Conflict is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians dropped a another explosive on him.” He added: “Everything in the village is destroyed. There are UAVs everywhere and casualties. Ours and the enemy's.”

The soldier said his squad spent over a month in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to reach their position was on foot. Necessary provisions came by drone: food and water. Seven days following he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a nurse provided him with new civilian clothes: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I think I was lucky to survive. My cousin has been lost. We face ongoing explosions.” A builder working in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors laid him on a bed, took off a stained bandage and treated his recent injury from fragments. Covered in a thermal sheet, he used a mobile phone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my unit. Someone has to defend our nation,” he said.

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

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, obstetric units and ambulances. Per human rights groups, over two hundred health workers have been fatally attacked in nearly two thousand attacks. The underground facility is constructed from four steel bunkers, with wooden supports, soil and granular material placed above reaching the surface. It is designed to resist impacts from 152mm projectiles and even multiple 8kg explosive devices dropped by drone.

A major steel and mining company, which funded the building, plans to build 20 facilities in all. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “vitally important for preserving the survival of our armed forces and assisting troops on the frontline.” The company described the initiative as the “most ambitious and demanding” it had undertaken since the enemy's invasion.

An example of the centre’s surgical rooms.

The surgeon, explained certain injured soldiers had to endure delays many hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had two severely injured casualties who came at the early hours. I had to perform a removal of both limbs on one of them. The soldier's tourniquet had been applied for so long there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he said.

Medical assistants transported the soldier through the tunnel and into an ambulance. The transport was stationed under a shrub. He and the two other military members were transferred to the urban center of a major city for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, the mascot, padded up to the entrance to await the next arrivals. “We are active around the clock,” Holovashchenko said. “The work is continuous.”