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Scrubby trees conceal the entryway. One descending timber passageway leads down to a well-illuminated reception area. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and breathing machines. Plus shelves full of medical equipment, medications and neat piles of spare clothes. Within a staff room with a laundry appliance and hot water heater, doctors keep an eye on a screen. The screen reveals the movements of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center observe a monitor showing enemy suicide and surveillance UAVs in the region.

This is Ukraine’s secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the ground. This is the safest method of providing help to our injured military personnel. And it keeps healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of enemy FPV aerial devices, which drop grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We encounter minimal bullet injuries. It’s an era of drones and a different kind of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the underground facility for caring for injured soldiers in the eastern region.

During one day last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his leg. “War is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the Russians dropped a another explosive on him.” He continued: “All structures in the settlement is demolished. We see drones all around and casualties. Ours and theirs.”

Dvorskyi explained his unit spent over a month in a forest area near the city, which enemy forces has been attempting to capture for many months. The only way to get to their position was on foot. All supplies arrived by quadcopter: rations and drinking water. A week following he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a nurse provided him with new non-military attire: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had left him with a head injury. “My position was in a trench shelter. Suddenly it became black. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to survive. A relative has been killed. There are ongoing detonations.” A construction worker employed in Lithuania, he said he had returned to his homeland and volunteered to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a medical cot, took off a stained dressing and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he used a cellphone to call his family member. “A fragment of mortar struck me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a few months. After that, to go back to my unit. Our forces has to defend our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. According to international monitors, over two hundred health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, earth and granular material laid on top reaching the surface. It is designed to resist impacts from large-caliber projectiles and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 facilities in all. The head of the nation's national security council and former military leader, Rustem Umerov, said they would be “vitally important for saving the survival of our armed forces and supporting defenders on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had implemented since Russia’s invasion.

An example of the centre’s operating theatres.

The surgeon, said some injured personnel had to wait hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received a pair of critically ill patients who came at the early hours. I had to carry out a double amputation on a patient. His tourniquet had been on for so long there was no other option.” How did he cope with traumatic surgeries? “I’ve been healthcare for 20 years. One must concentrate,” he said.

Orderlies transported the soldier through the passage and into an ambulance. The vehicle was parked under a shrub. The patient and the other military members were transferred to the urban center of Dnipro for further treatment. The subterranean hospital staff paused for rest. The facility's ginger cat, Vasilevs, walked toward the entrance to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”