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Scrubby foliage conceal the entryway. A descending wooden passageway descends to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and ventilators. Plus cabinets full of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Hospital personnel at an subterranean medical center look at a screen showing Russian suicide and reconnaissance drones in the region.

This is the nation's covert underground medical facility. The facility began operations in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of Pokrovsk in the Donetsk region. “We are 6 metres below the ground. This is the most secure way of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring amputations, or serious abdominal injuries. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our patients are from FPVs. We see few gunshot wounds. It’s an era of drones and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded troops in eastern Ukraine.

During one day last week, a group of three military members limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces dropped a another grenade on him.” He added: “All structures in the settlement is demolished. We see UAVs all around and bodies. Ours and the enemy's.”

Dvorskyi explained his squad spent over a month in a wooded zone close to the city, which enemy forces has been attempting to capture for many months. Sole access to get to their position was on foot. Necessary provisions arrived by drone: rations and drinking water. Seven days following he was injured, he traveled 5km (about 3 miles), requiring three hours, to a point where an military transport was able to evacuate him. At the clinic, a medic checked his physical condition. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a pair of pale jeans.

The soldier, 28, said a FPV aerial device caused a small hole in his lower limb.

Another patient, 38-year-old a serviceman, said a drone blast had left him with concussion. “My position was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. There are continuous explosions.” A construction worker employed in Lithuania, Filipchuk noted he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, 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 recent injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to ring his family member. “A fragment of artillery hit me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. This may require a few months. Subsequently, to go back to my military group. Our forces has to protect our country,” he affirmed.

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

Since 2022, enemy forces has repeatedly attacked medical centers, clinics, obstetric units and emergency vehicles. Per human rights groups, 261 medical personnel have been fatally attacked in almost two thousand assaults. The underground facility is constructed from multiple steel bunkers, with wooden supports, earth and sand laid on top up to ground level. It can withstand impacts from 152mm projectiles and even three eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which financed the construction, plans to erect 20 facilities in total. A senior official of the nation's national security council and former military leader, Rustem Umerov, declared they would be “vitally essential for preserving the lives of our military and supporting troops on the battlefront.” The company referred to the project as the “largest-scale and demanding” it had undertaken after the enemy's military offensive.

An example of the centre’s surgical rooms.

The surgeon, said some wounded soldiers had to endure delays hours or even multiple days before they could be transported due to the threat of air assaults. “Our facility received two critically ill casualties who came at the early hours. It was necessary to carry out a removal of both limbs on one of them. His tourniquet had been applied for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “I’ve been healthcare for 20 years. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked beneath a bush. He and the other military members were transferred to the urban center of a major city for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, Vasilevs, walked up to the entrance to await the incoming patients. “We are active around the clock,” Holovashchenko said. “The work is continuous.”