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Scrubby foliage hide the entrance. One sloping wooden tunnel descends to a well-illuminated welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and breathing machines. And cabinets full of healthcare supplies, drugs and neat piles of extra garments. In a staff room with a laundry appliance and kettle, physicians monitor a display. It shows the movements of enemy surveillance UAVs as they weave in the sky above.

Medical staff at an subterranean medical center observe a monitor displaying enemy suicide and reconnaissance drones in the region.

Welcome to Ukraine’s covert below-ground medical facility. This center opened in August and is the second of its kind, situated in the eastern part of the country close to the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits six meters below the ground. This is the safest way of delivering care to our injured soldiers. And it keeps medical personnel safe,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or severe stomach wounds. Others can walk. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with deadly precision. “Ninety per cent of our patients are from first-person view drones. We see minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for caring for wounded soldiers in eastern Ukraine.

On one day last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone explosion had torn a minor wound in his leg. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the enemy forces released a second grenade on him.” He continued: “All structures in the settlement is destroyed. We see UAVs all around and bodies. Our side's and theirs.”

The soldier explained his squad endured over a month in a wooded zone near the city, which Russia has been trying to seize since last year. The only way to get to their location was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week following he was injured, he walked 5km (about 3 miles), taking several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his vital signs. Following care, a nurse provided him with new civilian clothes: a shirt and a set of light-colored jeans.

The soldier, twenty-eight, stated a first-person view aerial device ripped a small hole in his leg.

A different casualty, 38-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he said. “I believe I was fortunate to survive. My cousin has been killed. We face continuous explosions.” A builder working in a neighboring country, he noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as doctors placed him on a bed, took off a bloody dressing and treated his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his sister. “A fragment of mortar struck me. The cause was a ricochet. 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 military group. Someone must defend our country,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the back by a piece of artillery shell.

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, obstetric units and ambulances. Per human rights groups, over two hundred health workers have been killed in nearly 2,000 attacks. The underground facility is built from multiple reinforced shelters, with wooden supports, soil and granular material placed above reaching ground level. It is designed to resist impacts from large-caliber projectiles and even multiple 8kg TNT charges released by aerial means.

A major industrial group, which funded the building, plans to erect twenty facilities in all. A senior official of the nation's national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our armed forces and supporting troops on the frontline.” The organization described the project as the “most ambitious and challenging” it had implemented after Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, said certain injured personnel had to endure delays hours or even multiple days before they could be transported because of the danger of air assaults. “Our facility received a pair of critically ill casualties who arrived at the early hours. I had to carry out a double amputation on one of them. The soldier's bleeding control device had been on for such an extended period there was no alternative.” What is his method with severe operations? “My career in medicine for 20 years. One must focus,” he said.

Medical assistants wheeled the soldier up the tunnel and into an ambulance. The transport was stationed under a bush. The patient and the two other military members were transferred to the city of a major city for further treatment. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, padded up to the doorway to await the incoming patients. “Our facility operates active 24 hours a day,” the surgeon said. “The work is continuous.”