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Sparse trees conceal the entrance. A descending wooden passageway descends to a brightly lit welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, medications and organized stacks of extra garments. Within a staff room with a washing machine and kettle, doctors keep an eye on a screen. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Hospital personnel at an subterranean hospital look at a monitor displaying enemy suicide and reconnaissance UAVs in the area.

This is Ukraine’s covert below-ground medical facility. This center opened in August and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “We are six meters under the earth. This is the most secure method of providing help to our injured soldiers. It also ensures healthcare workers protected,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station handles 30-40 patients a each day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. The vast majority are the victims of Russian FPV drones, which release explosives with deadly precision. “90% of our patients are from FPVs. We see minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of conflict,” the surgeon said.

Major the senior surgeon at the underground facility for caring for injured soldiers in eastern Ukraine.

During one day last week, three military members limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an FPV explosion had ripped a small hole in his leg. “War is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Subsequently the Russians dropped a second explosive on him.” He continued: “All structures in the settlement is destroyed. We see UAVs everywhere and bodies. Ours and the enemy's.”

Dvorskyi said his squad spent over a month in a forest area close to the city, which Russia has been trying to seize for many months. Sole access to get to their position was by walking. All supplies came by quadcopter: rations and drinking water. A week after he was injured, he walked 5km (roughly three miles), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a nurse gave him fresh non-military attire: a T-shirt and a pair of light-colored jeans.

The soldier, 28, said a first-person view drone ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I think I was lucky to survive. A relative has been lost. There are ongoing explosions.” A builder working in Lithuania, he noted he had returned to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff laid him on a medical cot, removed a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A piece of artillery struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. Subsequently, to return to my unit. Our forces must defend our country,” he said.

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

Over the past years, enemy forces has consistently attacked medical centers, health facilities, obstetric units and emergency vehicles. Per human rights groups, over two hundred medical personnel have been fatally attacked in almost 2,000 assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, soil and granular material placed above reaching the surface. It is designed to resist impacts from 152mm projectiles and even three 8kg explosive devices released by aerial means.

A major industrial group, which funded the construction, plans to erect 20 facilities in total. The head of Ukraine’s security agency and former defence minister, the official, said they would be “critically important for saving the lives of our military and supporting troops on the battlefront.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken after the enemy's invasion.

An example of the centre’s operating theatres.

The surgeon, said some injured personnel had to endure delays hours or even multiple days before they could be evacuated because of the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to carry out a removal of both limbs on a patient. His tourniquet had been on for so long there was no alternative.” What is his method with severe operations? “I’ve been healthcare for 20 years. You have to focus,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was parked under a bush. He and the other military members were transferred to the city of a major city for additional medical care. The underground hospital staff paused for rest. The facility's ginger cat, Vasilevs, walked up to the entrance to greet the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”