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Sparse foliage conceal the entrance. A sloping wooden tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, heart rate sensors and breathing machines. And cabinets full of medical equipment, drugs and neat piles of spare clothes. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. It shows the movements of enemy spy drones as they zigzag in the air above.

Medical personnel at an underground hospital observe a monitor showing Russian suicide and surveillance UAVs in the area.

This is Ukraine’s covert below-ground medical facility. The facility began operations 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. “We are 6 metres below the ground. This is the safest way of delivering care to our injured military personnel. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point handles thirty to forty casualties a each day. Their conditions vary. Some have devastating limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy first-person view (FPV) drones, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We see few bullet injuries. This is an era of drones and a new type of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean facility for caring for wounded troops in the eastern region.

During one day recently, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an FPV explosion had ripped a small hole in his leg. “Conflict is terrible. The guy beside me, a fellow soldier, was killed,” he stated. “He collapsed. Then the Russians released a second grenade on him.” He added: “Everything in the settlement is destroyed. We see drones everywhere and casualties. Ours and theirs.”

Dvorskyi said his unit endured 43 days in a wooded zone close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their position was on foot. Necessary provisions came by drone: rations and drinking water. A week after he was hurt, he walked 5km (roughly three miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medic checked his vital signs. Following care, a medical attendant gave him new non-military attire: a shirt and a set of light-colored denim trousers.

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

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to survive. My cousin has been killed. There are ongoing explosions.” A builder working in Lithuania, Filipchuk said he had returned to his homeland and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as doctors placed him on a medical cot, removed a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To get better. That will take a few months. After that, to go back to my military group. Someone has to protect our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. Per international monitors, over two hundred health workers have been fatally attacked in nearly two thousand attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material laid on top up to ground level. It can withstand impacts from 152mm artillery shells and even multiple 8kg TNT charges dropped by drone.

A major steel and mining company, which financed the construction, intends to erect 20 units in all. The head of Ukraine’s national security council and former military leader, Rustem Umerov, said they would be “vitally essential for saving the survival of our armed forces and supporting defenders on the frontline.” The company referred to the project as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, explained some wounded soldiers had to wait many hours or even multiple days before they could be transported due to the danger of air assaults. “Our facility received two severely injured casualties who arrived at the early hours. I had to perform a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic operations? “I’ve been healthcare for two decades. One must focus,” he remarked.

Orderlies transported Mykolaichuk through the tunnel and into an ambulance. The transport was parked under a bush. He and the two other military members were taken to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The facility's ginger cat, Vasilevs, padded up to the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko stated. “The work is continuous.”