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Scrubby foliage conceal the entrance. One sloping timber tunnel descends to a brightly lit reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. And shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a staff room with a washing machine and kettle, doctors keep an eye on a screen. The screen reveals the movements of Russian spy drones as they zigzag in the air above.

Medical staff at an underground medical center look at a screen displaying enemy suicide and surveillance drones in the region.

Welcome to Ukraine’s covert below-ground medical facility. This center began operations in August and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters below the ground. This is the most secure way of providing help to our wounded military personnel. And it keeps medical personnel safe,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a each day. Cases differ widely. Some have catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our cases are from first-person view drones. We see few bullet injuries. It’s an era of drones and a new type of war,” the surgeon explained.

Major the senior surgeon at the underground facility for caring for wounded troops in the eastern region.

During one afternoon last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days in a wooded zone near the city, which Russia has been attempting to capture since last year. The only way to get to their location was by walking. Necessary provisions arrived by quadcopter: rations and water. Seven days after he was injured, he traveled 5km (about 3 miles), requiring three hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff checked his vital signs. Following care, a nurse provided him with new non-military attire: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view drone ripped a small hole in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it became black. I lost sensation anything or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been lost. We face continuous detonations.” A builder working in Lithuania, he said he had returned to his homeland and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He groaned as doctors laid him on a medical cot, removed a stained bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. After that, to return to my military group. Our forces must protect our country,” he affirmed.

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

Since 2022, Russia has consistently targeted medical centers, clinics, maternity wards and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost 2,000 attacks. The underground facility is built from four reinforced shelters, with timber beams, soil and granular material laid on top reaching ground level. It can withstand impacts from large-caliber projectiles and even multiple eight-kilogram TNT charges dropped by aerial means.

A major steel and mining company, which funded the construction, intends to erect 20 facilities in all. The head of the nation's security agency and former military leader, Rustem Umerov, said they would be “critically essential for saving the survival of our military and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken after the enemy's invasion.

One of the centre’s surgical rooms.

The surgeon, said certain injured soldiers had to endure delays hours or even days before they could be evacuated due to the danger of aerial attacks. “We had a pair of severely injured casualties who came at the early hours. It was necessary to perform a double amputation on one of them. His bleeding control device had been on for so long there was no other option.” What is his method with traumatic operations? “My career in medicine for two decades. One must concentrate,” he said.

Orderlies wheeled the soldier up the tunnel and into an emergency vehicle. The transport 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 underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates open around the clock,” Holovashchenko said. “It doesn’t stop.”