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Scrubby foliage conceal the entrance. One descending timber passageway descends to a brightly lit reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, drugs and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, doctors monitor a screen. It shows the movements of enemy surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital observe a monitor displaying enemy suicide and surveillance drones in the region.

This is the nation's covert below-ground medical facility. The facility opened in the eighth month 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 Donetsk oblast. “Our facility sits six meters under the ground. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers safe,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles 30-40 patients a each day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or serious abdominal injuries. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop explosives with lethal accuracy. “90% of our patients are from FPVs. We encounter few bullet injuries. It’s an era of drones and a different kind of conflict,” the surgeon said.

Major the senior surgeon at the subterranean installation for caring for injured troops in eastern Ukraine.

On one afternoon recently, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion 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. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is destroyed. We see UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his unit spent over a month in a forest area near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their location was by walking. Necessary provisions came by quadcopter: food and water. Seven days after he was hurt, he walked 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a set of pale jeans.

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

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in concussion. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or hear anything,” he said. “I believe I was lucky to survive. My cousin has been lost. We face continuous detonations.” A builder working in a neighboring country, he said he had returned to Ukraine and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a bed, removed a stained dressing and cleaned his recent shrapnel wound. Covered in a thermal sheet, he used a cellphone to ring his sister. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. That will take a several months. After that, to return to my military group. Our forces has to protect our country,” he said.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently attacked hospitals, health facilities, obstetric units and ambulances. Per international monitors, 261 health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple reinforced shelters, with timber beams, soil and granular material placed above reaching the surface. It can withstand impacts from large-caliber artillery shells and even three eight-kilogram explosive devices dropped by aerial means.

A major steel and mining company, which financed the construction, intends to erect 20 facilities in all. The head of the nation's security agency and former military leader, Rustem Umerov, declared they would be “critically important for preserving the survival of our military and assisting defenders on the battlefront.” The company described the project as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, explained some injured soldiers had to endure delays many hours or even days before they could be evacuated due to the danger of air assaults. “Our facility received a pair of critically ill patients who came at the early hours. I had to carry out a double amputation on a patient. The soldier's tourniquet had been on for so long there was no other option.” How did he cope with traumatic operations? “I’ve been medicine for 20 years. One must concentrate,” he remarked.

Medical assistants transported the soldier through the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the two other military members were taken to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, Vasilevs, padded toward the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “The work is continuous.”