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Scrubby foliage conceal the entryway. One sloping timber passageway descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. And cabinets full of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a washing machine and kettle, physicians keep an eye on a display. The screen reveals the flight patterns of Russian spy drones as they weave in the air above.

Medical staff at an subterranean medical center look at a screen displaying Russian kamikaze and surveillance UAVs in the region.

This is Ukraine’s secret below-ground medical facility. The facility opened in August and is the second such installation, located in eastern Ukraine close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. It’s the safest way of providing help to our injured military personnel. It also ensures healthcare workers safe,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Their conditions vary. Some have devastating limb trauma necessitating surgical removal, or severe stomach wounds. Others can walk. Almost all are the victims of Russian FPV aerial devices, which drop grenades with deadly precision. “90% of our cases are from FPVs. We see few gunshot wounds. It’s an era of drones and a different kind of conflict,” the surgeon said.

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

On one day last week, three soldiers limped into the facility. The most lightly injured, 28-year-old one soldier, said an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is terrible. The guy next to me, Vasyl, was killed,” he stated. “He collapsed. Then the Russians released a another explosive on him.” He continued: “Everything in the village is destroyed. We see UAVs all around and casualties. Ours and theirs.”

The soldier explained his squad spent 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 on foot. All supplies came by quadcopter: food and water. A week after he was hurt, he traveled 5km (roughly three miles), taking three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic checked his vital signs. After treatment, a nurse provided him with new non-military attire: a T-shirt and a set of pale jeans.

The soldier, 28, said a FPV aerial device caused a small hole in his leg.

A different casualty, 38-year-old a serviceman, said a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he explained. “I think I was fortunate to remain alive. My cousin has been killed. We face ongoing detonations.” A construction worker working in Lithuania, Filipchuk said he had returned to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the back. He expressed pain as doctors placed him on a medical cot, removed a stained bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to call his family member. “A piece of artillery hit me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. This may require a several months. After that, to return to my military group. Our forces must defend our nation,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a fragment of mortar.

Over the past years, Russia has consistently targeted hospitals, clinics, obstetric units and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple steel bunkers, with wooden supports, soil and sand placed above reaching ground level. It is designed to resist impacts from large-caliber artillery shells and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect 20 facilities in total. The head of the nation's national security council and former defence minister, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and supporting troops on the frontline.” The organization described the initiative as the “largest-scale and challenging” it had implemented since the enemy's invasion.

An example of the facility's surgical rooms.

The surgeon, explained some injured personnel had to wait many hours or even days before they could be evacuated because of the danger of aerial attacks. “We had two critically ill patients who arrived at 3am. It was necessary to carry out a removal of both limbs on a patient. The soldier's tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in medicine for two decades. One must focus,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the other military members were taken to the city of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, Vasilevs, padded up to the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”