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Sparse trees conceal the entryway. A descending timber tunnel descends to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, medications and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, physicians keep an eye on a screen. The screen reveals the movements of enemy surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital observe a screen displaying Russian suicide and surveillance drones in the area.

Welcome to Ukraine’s secret below-ground medical facility. This center opened in the eighth month and is the second of its kind, situated in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. It’s the safest method of providing help to our injured military personnel. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the casualties of enemy FPV aerial devices, which drop explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see few bullet injuries. It’s an era of drones and a different kind of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean facility for caring for wounded troops in the eastern region.

During one afternoon recently, three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone blast had ripped a minor wound in his leg. “War is terrible. The guy beside me, Vasyl, was killed,” he said. “He fell down. Then the enemy forces released a another grenade on him.” He continued: “Everything in the settlement is demolished. There are drones all around and casualties. Ours and theirs.”

Dvorskyi explained his squad spent 43 days 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 arrived by drone: food and water. Seven days after he was injured, he traveled five kilometers (roughly three miles), taking several hours, to a point where an military transport was able to pick him up. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant provided him with new non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a FPV drone ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a dugout. It suddenly went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been lost. There are ongoing detonations.” A builder working in a neighboring country, Filipchuk noted he had come back to his homeland and volunteered to fight shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff laid him on a medical cot, removed a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to call his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a few months. After that, to return to my unit. Our forces has to protect our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is constructed from multiple steel bunkers, with timber beams, earth and sand placed above reaching the surface. It is designed to resist direct hits from 152mm projectiles and even multiple eight-kilogram explosive devices released by drone.

A major industrial group, which financed the building, intends to build 20 units in all. A senior official of Ukraine’s security agency and former defence minister, the official, declared they would be “critically important for preserving the lives of our armed forces and supporting defenders on the frontline.” The company referred to the project as the “most ambitious and demanding” it had implemented since Russia’s military offensive.

An example of the centre’s surgical rooms.

The surgeon, said some injured soldiers had to wait many hours or even days before they could be evacuated due to the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at 3am. I had to perform a removal of both limbs on one of them. His tourniquet had been applied for such an extended period there was no other option.” How did he cope with severe operations? “My career in healthcare for 20 years. One must focus,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an emergency vehicle. The transport was stationed under a bush. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, the mascot, walked toward the entrance to await the incoming patients. “We are active around the clock,” the surgeon said. “It doesn’t stop.”