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Sparse foliage conceal the entrance. A descending wooden passageway leads down to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

Medical staff at an underground medical center observe a screen showing Russian kamikaze and surveillance UAVs in the region.

Welcome to Ukraine’s covert underground medical facility. The facility began operations in August and is the second of its kind, located in the eastern part of the country close to the combat zone and the city of Pokrovsk in Donetsk oblast. “We are six meters under the earth. This is the most secure way of providing help to our injured soldiers. And it keeps healthcare workers protected,” said the clinic’s surgeon, Major the chief surgeon.

This medical station handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop grenades with lethal accuracy. “90% of our cases are from FPVs. We encounter few bullet injuries. This is an age of unmanned aircraft and a new type of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the underground facility for caring for injured troops in the eastern region.

On one day last week, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, said an first-person view drone explosion had torn a small hole in his limb. “War is terrible. My comrade 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 drones everywhere and bodies. Our side's and theirs.”

Dvorskyi said his unit spent 43 days in a wooded zone close to the city, which enemy forces has been trying to seize since last year. The only way to get to their location was on foot. Necessary provisions came by drone: food and water. A week following he was injured, he walked 5km (roughly three miles), taking several hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a set of pale denim trousers.

The soldier, 28, stated a FPV drone ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. There are continuous explosions.” A builder employed in Lithuania, he said he had returned to his homeland and volunteered to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, 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 recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A fragment of mortar hit me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To get better. That will take a several months. After that, to return to my unit. Our forces has to defend our nation,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. Per human rights groups, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is built from four reinforced shelters, with timber beams, soil and sand laid on top up to the surface. It is designed to resist direct hits from large-caliber artillery shells and even three 8kg explosive devices released by drone.

The Ukrainian industrial group, which funded the construction, intends to build 20 units in total. A senior official of Ukraine’s national security council and ex- defence minister, the official, said they would be “critically essential for preserving the survival of our military and assisting troops on the frontline.” The organization referred to the initiative as the “most ambitious and challenging” it had undertaken after the enemy's invasion.

One of the centre’s operating theatres.

The surgeon, explained certain injured personnel had to wait many hours or even days before they could be transported due to the danger of aerial attacks. “Our facility received two critically ill patients who came at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “My career in medicine for 20 years. You have to concentrate,” he said.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The transport was parked beneath a shrub. He and the two other military members were transferred to the city of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, walked up to the doorway to await the next arrivals. “Our facility operates open 24 hours a day,” Holovashchenko said. “The work is continuous.”