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Sparse foliage hide the entrance. One sloping timber passageway leads down to a brightly lit reception area. Inside lies a surgery unit, equipped with beds, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center observe a screen displaying Russian suicide and surveillance drones in the area.

This is the nation's secret underground medical facility. This center began operations in August and is the second of its kind, located in the eastern part of the country close to the frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters below the earth. This is the safest method of providing help to our injured military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Maj the chief surgeon.

This medical station treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of enemy FPV aerial devices, which release grenades with deadly accuracy. “90% of our cases are from first-person view drones. We see few gunshot wounds. It’s an era of drones and a different kind of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean installation for treating injured soldiers in the eastern region.

On one afternoon recently, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had ripped a minor wound in his limb. “War is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a second explosive on him.” He added: “All structures in the village is destroyed. There are UAVs everywhere and casualties. Ours and theirs.”

The soldier said his unit endured 43 days in a wooded zone near the city, which Russia has been attempting to capture for many months. Sole access to get to their position was by walking. Necessary provisions came by drone: food and drinking water. A week following he was injured, he walked five kilometers (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, stated a FPV drone caused a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to remain alive. A relative has been killed. We face ongoing detonations.” A builder working in Lithuania, he said he had come back to Ukraine and enlisted to fight shortly 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 medical staff placed him on a medical cot, removed a stained dressing 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 artillery struck me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. That will take a few months. After that, to go back to my unit. Someone has to defend our country,” he affirmed.

Medical staff care for the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently targeted hospitals, clinics, obstetric units and ambulances. Per human rights groups, over two hundred medical personnel have been killed in almost 2,000 attacks. The underground facility is constructed from four reinforced shelters, with timber beams, soil and granular material laid on top reaching ground level. It can withstand impacts from large-caliber projectiles and even three 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, intends to build 20 units in total. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, declared they would be “critically important for saving the lives of our military and supporting defenders on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

One of the facility's surgical rooms.

The surgeon, explained some injured soldiers had to wait hours or even multiple days before they could be transported due to the danger of air assaults. “Our facility received two critically ill casualties who arrived at 3am. I had to carry out a removal of both limbs on a patient. His tourniquet had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been medicine for 20 years. You have to focus,” he remarked.

Medical assistants transported the soldier through the tunnel and into an ambulance. The vehicle was parked under a bush. The patient and the two other soldiers were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's ginger cat, Vasilevs, padded up to the entrance to await the incoming patients. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”