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Sparse foliage conceal the entryway. A sloping timber tunnel leads down to a well-illuminated reception area. There is a surgery unit, equipped with gurneys, cardiac monitors and ventilators. And cabinets full of medical equipment, drugs and neat piles of spare clothes. Within a break area with a washing machine and kettle, doctors monitor a display. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

Medical personnel at an underground hospital look at a screen showing Russian suicide and surveillance drones in the region.

This is Ukraine’s secret below-ground medical facility. This center began operations in the eighth month and is the second such installation, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits six meters under the ground. This is the most secure method of providing help to our wounded military personnel. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or serious stomach wounds. Others can walk. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which release grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major the senior surgeon at the underground installation for treating wounded soldiers in the eastern region.

During one afternoon recently, a group of three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone blast had ripped a minor wound in his leg. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a second explosive on him.” He continued: “All structures in the settlement is destroyed. We see drones all around and bodies. Our side's and theirs.”

The soldier said his unit endured over a month in a forest area near the city, which Russia has been attempting to capture for many months. Sole access to reach their location was by walking. All supplies arrived by drone: food and water. Seven days following he was hurt, he traveled 5km (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a medical attendant gave him fresh civilian clothes: a shirt and a pair of light-colored denim trousers.

The soldier, 28, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation anything or any sound,” he said. “I think I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A construction worker employed in a neighboring country, Filipchuk said he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a bed, removed a stained dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A piece of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. Subsequently, to go back to my military group. Someone has to defend our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the dorsal area by a piece of mortar.

Since 2022, enemy forces has consistently targeted medical centers, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in nearly 2,000 assaults. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material placed above reaching the surface. It can withstand direct hits from 152mm projectiles and even three 8kg explosive devices released by aerial means.

A major industrial group, which financed the construction, intends to build 20 units in all. A senior official of the nation's national security council and former military leader, the official, said they would be “vitally important for saving the survival of our military and assisting defenders on the frontline.” The company described the initiative as the “largest-scale and demanding” it had undertaken since the enemy's invasion.

One of the centre’s surgical rooms.

Holovashchenko, explained some wounded personnel had to endure delays hours or even multiple days before they could be transported because of the danger of aerial attacks. “Our facility received two critically ill patients who came at 3am. It was necessary to perform a double amputation on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with severe surgeries? “My career in healthcare for two decades. You have to concentrate,” he said.

Orderlies transported the soldier through the passage and into an emergency vehicle. The transport was stationed under a shrub. He and the two other soldiers were transferred to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The facility's orange feline, Vasilevs, padded up to the entrance to greet the incoming patients. “We are open 24 hours a day,” the surgeon stated. “It doesn’t stop.”