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Sparse trees conceal the entrance. A descending wooden passageway descends to a brightly lit welcome zone. Inside lies a operating ward, equipped with beds, cardiac monitors and breathing machines. And cabinets full of medical equipment, drugs and organized stacks of extra garments. In a staff room with a laundry appliance and kettle, doctors monitor a screen. It shows the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Medical personnel at an underground hospital look at a monitor displaying enemy kamikaze and surveillance drones in the region.

This is the nation's covert below-ground medical facility. The facility opened in August and is the second of its kind, located in the eastern part of the country not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the safest method of providing help to our injured military personnel. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Some have catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop explosives with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. This is an age of drones and a different kind of war,” the surgeon said.

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

During one day recently, three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his limb. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a another grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Ours and theirs.”

The soldier explained his squad endured 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their position was by walking. Necessary provisions came by drone: rations and drinking water. A week following he was injured, he traveled five kilometers (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic checked his physical condition. Following care, a nurse gave him new non-military attire: a T-shirt and a set of pale jeans.

The soldier, 28, said a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to survive. A relative has been lost. We face continuous explosions.” A builder employed in Lithuania, he said he had returned to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, removed a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his sister. “A piece of mortar hit 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. Our forces has to defend our country,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the back by a piece of mortar.

Over the past years, enemy forces has repeatedly attacked medical centers, clinics, maternity wards and emergency vehicles. Per international monitors, over two hundred medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, soil and granular material placed above reaching the surface. It can withstand direct hits from 152mm projectiles and even three eight-kilogram explosive devices released by aerial means.

The Ukrainian industrial group, which funded the building, plans to erect twenty units in total. The head of Ukraine’s national security council and former military leader, Rustem Umerov, declared they would be “critically important for saving the lives of our armed forces and assisting defenders on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken after the enemy's invasion.

An example of the centre’s surgical rooms.

The surgeon, explained some 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 a pair of severely injured patients who arrived at the early hours. It was necessary to perform a double amputation on one of them. The soldier's bleeding control device had been applied for such an extended period there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. One must focus,” he said.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the other soldiers were taken to the city of Dnipro for additional medical care. The subterranean medical team took a break. The hospital’s orange feline, Vasilevs, walked toward the doorway to await the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “The work is continuous.”