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Sparse foliage hide the entryway. A descending timber tunnel descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a laundry appliance and kettle, doctors monitor a display. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Medical personnel at an underground medical center observe a monitor displaying Russian suicide and reconnaissance UAVs in the area.

Welcome to Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second such installation, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in the Donetsk region. “We are 6 metres below the ground. It’s the most secure way of delivering care to our wounded soldiers. It also ensures medical personnel safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or severe stomach wounds. Some patients can move on their own. The vast majority are the casualties of enemy FPV aerial devices, which drop grenades with deadly accuracy. “90% of our cases are from FPVs. We encounter few gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the doctor explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for injured troops in eastern Ukraine.

During one day last week, a group of three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a minor wound in his limb. “War is terrible. The guy next to me, Vasyl, was killed,” he stated. “He fell down. Then the Russians dropped a second explosive on him.” He continued: “All structures in the settlement is destroyed. There are drones all around and bodies. Ours and theirs.”

Dvorskyi said his unit endured over a month in a wooded zone near the city, which Russia has been trying to seize for many months. The only way to reach their location was on foot. Necessary provisions came by drone: food and water. A week following he was hurt, he traveled five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. After treatment, a nurse provided him with fresh civilian clothes: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, stated a first-person view aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, recounted a UAV explosion had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he said. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous explosions.” A builder working in a neighboring country, Filipchuk said he had come back to his homeland and enlisted to fight days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff laid him on a bed, took off a stained bandage and treated his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to call his sister. “A piece of mortar hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. Subsequently, to return to my unit. Someone must protect our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was injured in the dorsal area by a piece of mortar.

Since 2022, Russia has consistently attacked hospitals, health facilities, obstetric units and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in almost two thousand assaults. The underground facility is built from four steel bunkers, with wooden supports, soil and sand placed above reaching the surface. It can withstand impacts from 152mm projectiles and even multiple 8kg TNT charges released by drone.

A major steel and mining company, which funded the building, intends to build 20 facilities in total. The head of the nation's national security council and former defence minister, Rustem Umerov, said they would be “critically essential for saving the lives of our military and supporting defenders on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented after the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said certain injured personnel had to wait hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “Our facility received a pair of severely injured casualties who came at 3am. I had to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for two decades. You have to focus,” he said.

Orderlies wheeled the soldier up the tunnel and into an emergency vehicle. The vehicle was parked under a shrub. He and the two other soldiers were transferred to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The facility's ginger cat, Vasilevs, walked toward the doorway to await the incoming patients. “We are active around the clock,” Holovashchenko stated. “It doesn’t stop.”