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Scrubby trees hide the entrance. A descending timber tunnel descends to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. And cabinets stocked of medical equipment, drugs and neat piles of extra garments. In a break area with a washing machine and kettle, physicians monitor a display. The screen reveals the movements of enemy spy drones as they zigzag in the sky above.

Hospital staff at an underground hospital observe a screen showing enemy suicide and reconnaissance drones in the region.

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 not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. This is the safest method of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian first-person view (FPV) aerial devices, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal bullet injuries. This is an era of drones and a different kind of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean installation for treating injured troops in the eastern region.

During one day last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an FPV blast had torn a small hole in his leg. “War is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces released a second explosive on him.” He continued: “All structures in the settlement is demolished. We see drones everywhere and bodies. Our side's and theirs.”

The soldier explained his unit endured over a month in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to reach their location was on foot. Necessary provisions arrived by quadcopter: rations and water. Seven days after he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his physical condition. After treatment, a nurse provided him with new non-military attire: a T-shirt and a pair of light-colored jeans.

The soldier, 28, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he said. “I think I was fortunate to remain alive. A relative has been killed. We face continuous detonations.” A builder working in a neighboring country, Filipchuk said he had come back to his homeland and enlisted to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff laid him on a bed, removed a stained bandage and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a few months. After that, to go back to my military group. Someone has to defend our country,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 medical personnel have been killed in almost two thousand assaults. The underground facility is constructed from four steel bunkers, with timber beams, earth and granular material placed above up to the surface. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges dropped by aerial means.

The Ukrainian industrial group, which financed the construction, intends to erect 20 units in total. The head of the nation's national security council and former military leader, the official, declared they would be “vitally essential for preserving the survival of our military and supporting troops on the frontline.” The company referred to the project as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

One of the facility's surgical rooms.

Holovashchenko, explained some injured personnel had to endure delays many hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had a pair of critically ill casualties who came at 3am. I had to perform a removal of both limbs on one of them. His bleeding control device had been on for so long there was no other option.” How did he cope with severe operations? “My career in healthcare for two decades. One must concentrate,” he said.

Orderlies wheeled the soldier through the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the other military members were transferred to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The facility's ginger cat, Vasilevs, padded toward the doorway to greet the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”