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Scrubby foliage conceal the entrance. One sloping wooden passageway descends to a well-illuminated reception area. Inside lies a surgery unit, equipped with beds, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, medications and organized stacks of extra garments. In a staff room with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an subterranean hospital observe a screen showing enemy kamikaze and surveillance drones in the region.

Welcome to Ukraine’s covert underground medical facility. This center began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are six meters below the earth. This is the most secure method of providing help to our wounded soldiers. It also ensures medical personnel protected,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. This is an era of unmanned aircraft and a different kind of war,” the doctor said.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded troops in eastern Ukraine.

On one day last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an FPV explosion had torn a minor wound in his leg. “Conflict is terrible. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the enemy forces released a another explosive on him.” He continued: “All structures in the village is demolished. There are drones everywhere and bodies. Ours and the enemy's.”

The soldier said his unit endured over a month in a forest area near Pokrovsk, which Russia has been attempting to capture for many months. Sole access to reach their position was on foot. Necessary provisions arrived by quadcopter: food and drinking water. A week after he was injured, he walked five kilometers (roughly three miles), requiring several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him new non-military attire: a T-shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, said a FPV drone ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or hear anything,” he explained. “I think I was fortunate to survive. My cousin has been killed. There are continuous explosions.” A construction worker employed in a neighboring country, Filipchuk noted he had returned to Ukraine and enlisted to fight shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a bed, removed a stained dressing and cleaned his recent injury from fragments. Covered in a thermal sheet, he used a cellphone to ring his sister. “A piece of mortar hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. After that, to go back to my unit. Our forces has to defend our country,” he affirmed.

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

Since 2022, enemy forces has repeatedly attacked hospitals, health facilities, maternity wards and emergency vehicles. Per human rights groups, over two hundred medical personnel have been killed in almost two thousand assaults. The underground facility is constructed from four steel bunkers, with wooden supports, earth and granular material laid on top up to the surface. It is designed to resist direct hits from 152mm artillery shells and even three eight-kilogram explosive devices dropped by drone.

The Ukrainian industrial group, which financed the building, plans to erect 20 units in all. A senior official of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and assisting troops on the battlefront.” The company referred to the initiative as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

One of the centre’s surgical rooms.

The surgeon, said certain wounded personnel had to wait many hours or even days before they could be transported due to the threat of air assaults. “Our facility received a pair of critically ill casualties who came at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's bleeding control device had been applied for such an extended period there was no other option.” What is his method with severe operations? “My career in healthcare for 20 years. You have to focus,” he said.

Medical assistants wheeled the soldier up the passage and into an ambulance. The vehicle was stationed under a shrub. He and the other military members were taken to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The hospital’s orange feline, Vasilevs, padded up to the doorway to greet the incoming patients. “We are open around the clock,” the surgeon said. “The work is continuous.”