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Sparse foliage hide the entrance. One sloping wooden passageway leads down to a well-illuminated welcome zone. There is a operating ward, equipped with gurneys, heart rate sensors and ventilators. Plus shelves full of medical equipment, medications and neat piles of extra garments. In a break area with a laundry appliance and kettle, physicians keep an eye on a screen. It shows the flight patterns of Russian spy drones as they zigzag in the sky above.

Hospital personnel at an subterranean hospital look at a monitor showing Russian suicide and surveillance drones in the area.

Welcome to Ukraine’s covert underground medical facility. This center opened in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. It’s the safest way of providing help to our injured military personnel. It also ensures healthcare workers protected,” stated the clinic’s lead doctor, Major the chief surgeon.

The stabilisation point treats thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries requiring amputations, or severe abdominal injuries. Others can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop grenades with deadly accuracy. “90% of our patients are from FPVs. We see minimal gunshot wounds. This is an era of drones and a different kind of conflict,” the surgeon said.

Maj the senior surgeon at the underground facility for treating wounded troops in eastern Ukraine.

During one day last week, a group of three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an FPV explosion had ripped a minor wound in his limb. “Conflict is horrific. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a another explosive on him.” He continued: “Everything in the village is demolished. There are drones everywhere and casualties. Our side's and theirs.”

The soldier explained his squad endured 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies arrived by drone: food and water. Seven days following he was injured, he traveled 5km (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a medical attendant provided him with new non-military attire: a shirt and a set of light-colored denim trousers.

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

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I believe I was fortunate to survive. My cousin has been killed. We face continuous detonations.” A builder working in a neighboring country, Filipchuk said he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a bed, took off a stained dressing and treated his two-day-old shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to call his family member. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. This may require a few months. After that, to return to my unit. Someone has to protect our nation,” he said.

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

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, maternity wards and ambulances. Per international monitors, 261 health workers have been killed in nearly 2,000 attacks. This subterranean hospital is built from four steel bunkers, with timber beams, soil and sand placed above reaching ground level. It can withstand direct hits from 152mm projectiles and even three eight-kilogram explosive devices released by aerial means.

The Ukrainian industrial group, which financed the building, intends to build 20 facilities in total. The head of Ukraine’s national security council and ex- military leader, Rustem Umerov, said they would be “vitally important for preserving the lives of our armed forces and supporting defenders on the frontline.” The organization described the project as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

An example of the centre’s surgical rooms.

The surgeon, said some injured personnel had to wait hours or even multiple days before they could be transported due to the danger of air assaults. “We had two severely injured patients who came at the early hours. It was necessary to carry out a double amputation on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic operations? “My career in healthcare for two decades. One must focus,” he remarked.

Medical assistants transported Mykolaichuk through the passage and into an ambulance. The transport was stationed under a shrub. He and the two other soldiers were taken to the city of a major city for further treatment. The subterranean medical team paused for rest. The facility's orange feline, the mascot, walked up to the entrance to greet the incoming patients. “Our facility operates active 24 hours a day,” the surgeon stated. “It doesn’t stop.”