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Scrubby trees conceal the entrance. A descending wooden tunnel leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves full of medical equipment, medications and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, physicians monitor a screen. It shows the movements of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground medical center look at a screen displaying enemy kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the most secure method of delivering care to our injured military personnel. It also ensures healthcare workers safe,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the doctor said.

Major the senior surgeon at the subterranean facility for treating injured troops in eastern Ukraine.

During one day recently, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a small hole in his leg. “Conflict is horrific. The guy beside me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the Russians released a another explosive on him.” He continued: “Everything in the village is demolished. We see drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit endured over a month in a forest area close to the city, which enemy forces has been trying to seize since last year. The only way to get to their location was by walking. All supplies came by drone: food and water. Seven days following he was hurt, he walked 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with new civilian clothes: a T-shirt and a set of pale jeans.

The soldier, 28, stated a first-person view drone caused a small hole in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in a head injury. “My position was in a dugout. It suddenly went dark. I couldn’t feel any feeling or any sound,” he said. “I think I was fortunate to remain alive. A relative has been killed. We face ongoing detonations.” A builder working in a neighboring country, he noted he had returned to his homeland and enlisted to fight shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, removed a stained bandage and treated his two-day-old shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of artillery struck me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to go back to my unit. Someone has to defend our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Since 2022, Russia has repeatedly targeted hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. The underground facility is constructed from multiple steel bunkers, with wooden supports, soil and sand placed above reaching ground level. It is designed to resist impacts from large-caliber projectiles and even multiple 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to erect 20 facilities in total. A senior official of the nation's security agency and ex- military leader, the official, said they would be “vitally important for saving the lives of our military and assisting troops on the battlefront.” The organization described the initiative as the “most ambitious and challenging” it had undertaken after the enemy's invasion.

An example of the facility's operating theatres.

Holovashchenko, explained some injured soldiers had to endure delays many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received two critically ill patients who arrived at the early hours. It was necessary to perform a double amputation on one of them. The soldier's tourniquet had been on for so long there was no alternative.” What is his method with severe operations? “I’ve been medicine for two decades. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed beneath a bush. The patient and the two other military members were taken to the urban center of a major city for additional medical care. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded up to the entrance to greet the incoming patients. “We are open 24 hours a day,” the surgeon said. “It doesn’t stop.”