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Scrubby foliage hide the entrance. One descending timber tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, equipped with beds, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, medications and organized stacks of spare clothes. In a staff room with a laundry appliance and kettle, physicians monitor a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the sky above.

Medical personnel at an underground medical center look at a screen showing Russian kamikaze and reconnaissance UAVs in the region.

This is Ukraine’s covert underground medical facility. The facility opened in the eighth month and is the second of its kind, located in eastern Ukraine close to the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the most secure way of providing help to our wounded soldiers. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Their conditions vary. Some have devastating leg injuries requiring surgical removal, or serious stomach wounds. Some patients can walk. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which release explosives with deadly precision. “90% of our cases are from FPVs. We encounter few bullet injuries. It’s an age of drones and a new type of conflict,” the surgeon explained.

Major the senior surgeon at the underground facility for treating injured troops in the eastern region.

During one day last week, a group of three soldiers limped into the hospital. The least severely hurt, 28-year-old one soldier, said an FPV explosion had ripped a minor wound in his limb. “War is terrible. The guy beside me, Vasyl, was killed,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He added: “All structures in the village is demolished. We see UAVs all around and bodies. Our side's and the enemy's.”

The soldier explained his unit endured over a month in a wooded zone close to Pokrovsk, which Russia has been trying to seize for many months. The only way to get to their location was by walking. Necessary provisions arrived by drone: food and water. A week following he was hurt, he walked 5km (roughly three miles), taking three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. Following care, a nurse provided him with new non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV drone caused a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “My position was in a dugout. It suddenly became black. I couldn’t feel any feeling or any sound,” he said. “I believe I was fortunate to remain alive. A relative has been killed. We face continuous detonations.” A builder employed in a neighboring country, he noted he had returned to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff placed him on a bed, took off a stained bandage and treated his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to return to my military group. Our forces must protect our country,” he affirmed.

Doctors care for the wounded soldier, who was hit in the back by a piece of mortar.

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, maternity wards and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and granular material placed above up to the surface. It can withstand direct hits from 152mm projectiles and even multiple 8kg explosive devices released by drone.

A major industrial group, which funded the construction, intends to build 20 units in total. A senior official of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “critically essential for saving the lives of our military and supporting defenders on the frontline.” The organization referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, said some injured personnel had to wait many hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received two critically ill patients who arrived at the early hours. I had to carry out a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with severe operations? “I’ve been healthcare for two decades. One must focus,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean medical team took a break. The hospital’s orange feline, the mascot, walked toward the doorway to greet the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”