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Scrubby foliage hide the entryway. A sloping timber tunnel leads down to a brightly lit reception area. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and organized stacks of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a screen. The screen reveals the movements of Russian spy drones as they weave in the air above.

Medical staff at an underground medical center look at a monitor showing Russian suicide and reconnaissance UAVs in the region.

Welcome to Ukraine’s covert below-ground medical facility. This center began operations in the eighth month and is the second such installation, situated in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the ground. It’s the most secure way of delivering care to our wounded military personnel. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a each day. Their conditions vary. Certain individuals suffer from devastating leg injuries necessitating amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the casualties of Russian FPV aerial devices, which release grenades with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

During one day recently, three military members limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had ripped a minor wound in his limb. “Conflict is terrible. My comrade beside me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians dropped a another explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs all around and bodies. Our side's and the enemy's.”

Dvorskyi explained his squad endured over a month in a wooded zone near the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was by walking. All supplies arrived by drone: rations and drinking water. A week after he was hurt, he walked five kilometers (about 3 miles), taking three hours, to where an military transport was able to pick him up. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him new civilian clothes: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device ripped a minor injury in his leg.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I lost sensation any feeling or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A construction worker working in a neighboring country, he said he had returned to Ukraine and enlisted to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as doctors placed him on a medical cot, took off a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his sister. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my unit. Our forces must protect our nation,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of mortar.

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, obstetric units and emergency vehicles. According to international monitors, 261 health workers have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and sand laid on top up to ground level. It is designed to resist impacts from 152mm artillery shells and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, plans to build twenty units in all. The head of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and supporting defenders on the battlefront.” The company referred to the project as the “largest-scale and challenging” it had implemented since Russia’s invasion.

One of the centre’s surgical rooms.

The surgeon, explained some wounded soldiers had to wait many hours or even days before they could be evacuated due to the danger of aerial attacks. “We had a pair of critically ill casualties who came at the early hours. It was necessary to carry out a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no other option.” What is his method with traumatic surgeries? “My career in healthcare for 20 years. You have to focus,” he remarked.

Medical assistants wheeled the soldier up the passage and into an ambulance. The transport was parked under a bush. The patient and the other soldiers were taken to the urban center of a major city for additional medical care. The underground medical team paused for rest. The facility's ginger cat, the mascot, padded up to the entrance to await the next arrivals. “We are active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”