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Sparse foliage conceal the entrance. One descending wooden passageway leads down to a well-illuminated reception area. There is a operating ward, equipped with beds, cardiac monitors and ventilators. And cabinets full of healthcare supplies, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and kettle, physicians monitor a screen. It shows the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Medical personnel at an subterranean medical center look at a screen showing enemy kamikaze and surveillance drones in the region.

Welcome to the nation's secret below-ground hospital. This center opened in the eighth month and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters below the earth. It’s the most secure way of delivering care to our injured soldiers. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Maj the chief surgeon.

This medical station treats thirty to forty patients a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring amputations, or serious stomach wounds. Some patients can walk. The vast majority are the casualties of Russian FPV drones, which release explosives with lethal accuracy. “90% of our cases are from first-person view drones. We encounter few bullet injuries. It’s an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in the eastern region.

During one afternoon last week, three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a minor wound in his limb. “Conflict is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a another grenade on him.” He continued: “Everything in the village is demolished. There are drones all around and casualties. Our side's and theirs.”

Dvorskyi said his unit endured 43 days in a forest area near the city, which Russia has been trying to seize for many months. Sole access to reach their location was on foot. Necessary provisions arrived by drone: rations and water. A week following he was hurt, he walked five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been killed. There are continuous detonations.” A builder employed in a neighboring country, Filipchuk noted he had returned to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors placed him on a bed, removed a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to go back to my military group. Someone has to defend our country,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Over the past years, Russia has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 medical personnel have been killed in nearly 2,000 assaults. The underground facility is constructed from four steel bunkers, with timber beams, soil and granular material laid on top reaching ground level. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg TNT charges released by aerial means.

A major steel and mining company, which financed the construction, intends to erect 20 facilities in all. The head of Ukraine’s security agency and former defence minister, the official, declared they would be “critically important for saving the lives of our military and assisting troops on the frontline.” The organization described the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

An example of the centre’s surgical rooms.

Holovashchenko, explained some wounded personnel had to wait hours or even days before they could be transported because of the danger of aerial attacks. “Our facility received two critically ill casualties who arrived at the early hours. I had to perform a double amputation on one of them. The soldier's tourniquet had been applied for so long there was no other option.” How did he cope with severe operations? “I’ve been healthcare for two decades. You have to concentrate,” he said.

Orderlies transported the soldier through the passage and into an ambulance. The transport was stationed under a shrub. The patient and the other soldiers were taken to the urban center of a major city for further treatment. The underground medical team took a break. The hospital’s orange feline, Vasilevs, walked up to the doorway to await the next arrivals. “We are active around the clock,” Holovashchenko said. “The work is continuous.”