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Sparse foliage conceal the entrance. A descending timber passageway descends to a brightly lit welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they weave in the air above.

Hospital staff at an underground medical center observe a monitor displaying Russian suicide and surveillance drones in the region.

This is Ukraine’s covert underground medical facility. This center opened in August and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the earth. It’s the most secure way of delivering care to our injured soldiers. And it keeps healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles 30-40 casualties a day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Others can move on their own. Almost all are the victims of Russian first-person view (FPV) aerial devices, which release explosives with lethal precision. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. This is an age of unmanned aircraft and a new type of war,” the surgeon said.

Major the senior surgeon at the subterranean installation for treating wounded troops in eastern Ukraine.

During one afternoon last week, three soldiers limped into the facility. The least severely hurt, 28-year-old one soldier, reported an FPV explosion had torn a minor wound in his leg. “War is horrific. My comrade next to me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians released a another grenade on him.” He added: “Everything in the village is demolished. We see UAVs everywhere and casualties. Ours and theirs.”

The soldier said his squad spent 43 days in a wooded zone near the city, which Russia has been attempting to capture for many months. Sole access to get to their position was on foot. All supplies arrived by drone: food and water. Seven days after he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a nurse provided him with new non-military attire: a T-shirt and a pair of light-colored jeans.

The soldier, twenty-eight, stated a first-person view drone caused a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to remain alive. A relative has been lost. We face continuous explosions.” A construction worker working in a neighboring country, he noted he had returned to his homeland and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, a serviceman, had been hit in the back. He expressed pain as medical staff laid him on a bed, removed a stained bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. This may require a several months. Subsequently, to return to my military group. Our forces must defend our nation,” he said.

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

Over the past years, enemy forces has repeatedly attacked hospitals, health facilities, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been killed in almost 2,000 assaults. The underground facility is built from four steel bunkers, with wooden supports, earth and granular material laid on top reaching the surface. It can withstand direct hits from 152mm artillery shells and even three eight-kilogram explosive devices released by aerial means.

The Ukrainian steel and mining company, which funded the construction, intends to erect twenty facilities in total. 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 defenders on the battlefront.” The organization described the project as the “largest-scale and challenging” it had implemented after Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, said certain injured personnel had to endure delays many hours or even days before they could be evacuated due to the threat of air assaults. “Our facility received two critically ill casualties who arrived at 3am. I had to carry out a double amputation on one of them. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants transported the soldier up the passage and into an emergency vehicle. The vehicle was stationed beneath a bush. He and the other soldiers were taken to the city of a major city for additional medical care. The underground medical team paused for rest. The facility's ginger cat, the mascot, padded up to the entrance to greet the next arrivals. “We are active around the clock,” the surgeon stated. “The work is continuous.”