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Sparse foliage hide the entryway. A descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with beds, heart rate sensors and ventilators. And shelves full of healthcare supplies, drugs and neat piles of extra garments. Within a break area with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of enemy spy drones as they weave in the air above.

Medical staff at an subterranean medical center observe a screen showing enemy suicide and surveillance drones in the area.

Welcome to Ukraine’s secret underground medical facility. This center began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the earth. This is the safest method of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty patients a day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the victims of Russian FPV aerial devices, which drop explosives with lethal precision. “90% of our patients are from FPVs. We see few gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground installation for treating injured soldiers in eastern Ukraine.

On one day last week, three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV explosion had torn a small hole in his limb. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a second grenade on him.” He added: “Everything in the settlement is destroyed. There are drones everywhere and casualties. Ours and the enemy's.”

The soldier explained his unit endured over a month in a forest area near Pokrovsk, which enemy forces has been attempting to capture for many months. The only way to reach their location was by walking. All supplies arrived by drone: rations and drinking water. Seven days following he was injured, he traveled five kilometers (roughly three miles), taking several hours, to a point where an military transport was able to pick him up. Upon arrival, a medic checked his vital signs. After treatment, a medical attendant provided him with new non-military attire: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, 28, said a first-person view drone caused a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly became black. I couldn’t feel anything or hear anything,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. There are continuous explosions.” A construction worker working in Lithuania, Filipchuk said he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a medical cot, removed a stained bandage and treated his recent injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of mortar struck me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my military group. Someone has to protect our nation,” he said.

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

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. Per human rights groups, over two hundred health workers have been killed in nearly 2,000 assaults. This subterranean hospital is built from four steel bunkers, with timber beams, soil and granular material placed above up to ground level. It is designed to resist direct hits from large-caliber projectiles and even multiple eight-kilogram TNT charges dropped by drone.

A major industrial group, which funded the building, plans to build 20 units in all. The head of the nation's security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for preserving the survival of our military and supporting defenders on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had undertaken after the enemy's military offensive.

One of the facility's surgical rooms.

Holovashchenko, explained certain wounded personnel had to wait hours or even multiple days before they could be evacuated because of the threat of air assaults. “Our facility received a pair of critically ill patients who came at 3am. It was necessary to perform a removal of both limbs 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 traumatic operations? “My career in healthcare for two decades. You have to focus,” he remarked.

Medical assistants transported Mykolaichuk through the tunnel and into an emergency vehicle. The transport was stationed under a shrub. He and the two other military members were transferred to the urban center of a major city for further treatment. The underground hospital staff took a break. The hospital’s orange feline, the mascot, padded toward the entrance to greet the next arrivals. “Our facility operates open around the clock,” the surgeon said. “The work is continuous.”