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Sparse trees hide the entrance. One descending timber tunnel leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. Plus cabinets full of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a washing machine and kettle, doctors monitor a screen. The screen reveals the movements of Russian spy drones as they zigzag in the sky above.

Medical staff at an underground hospital look at a monitor showing Russian suicide and reconnaissance UAVs in the region.

This is Ukraine’s secret below-ground medical facility. The facility began operations in the eighth month and is the second of its kind, located in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty patients a each day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop explosives with deadly precision. “Ninety per cent of our patients are from first-person view drones. We encounter few gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the surgeon explained.

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

On one afternoon last week, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a minor wound in his limb. “War is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians released a second explosive on him.” He continued: “Everything in the village is destroyed. There are drones everywhere and casualties. Ours and theirs.”

The soldier explained his unit endured over a month in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. The only way to reach their position was on foot. Necessary provisions arrived by drone: food and drinking water. Seven days following he was hurt, he traveled five kilometers (about 3 miles), taking three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his physical condition. Following care, a nurse gave him new civilian clothes: a shirt and a set of pale jeans.

The soldier, 28, stated a first-person view aerial device caused a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had left him with concussion. “My position was in a trench shelter. It suddenly became black. I lost sensation any feeling or hear anything,” he explained. “I think I was fortunate to remain alive. A relative has been killed. We face continuous explosions.” A builder employed in Lithuania, he said he had returned to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors laid him on a bed, removed a stained dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to call his sister. “A piece of mortar hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. After that, to return to my unit. Someone has to protect our nation,” he said.

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

Over the past years, Russia has repeatedly targeted medical centers, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred medical personnel have been fatally attacked in nearly two thousand attacks. The underground facility is built from multiple steel bunkers, with timber beams, earth and sand laid on top reaching ground level. It is designed to resist direct hits from large-caliber artillery shells and even multiple eight-kilogram TNT charges dropped by drone.

The Ukrainian industrial group, which financed the building, plans to build twenty units in total. The head of Ukraine’s security agency and ex- defence minister, the official, said they would be “critically essential for saving the lives of our armed forces and assisting defenders on the battlefront.” The company described the project as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said some wounded soldiers had to wait hours or even days before they could be evacuated due to the threat of air assaults. “We had a pair of critically ill casualties 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 other option.” How did he cope with traumatic surgeries? “I’ve been healthcare for 20 years. You have to focus,” he said.

Medical assistants transported Mykolaichuk through the tunnel and into an ambulance. The transport was stationed beneath a shrub. The patient and the other military members were taken to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, the mascot, walked up to the doorway to greet the incoming patients. “Our facility operates active 24 hours a day,” Holovashchenko stated. “The work is continuous.”