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Sparse foliage hide the entryway. One sloping wooden tunnel leads down to a brightly lit welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, drugs and neat piles of extra garments. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. It shows the flight patterns of Russian spy drones as they weave in the air above.

Medical personnel at an subterranean medical center look at a screen showing enemy kamikaze and surveillance UAVs in the region.

Welcome to Ukraine’s secret below-ground medical facility. This center began operations in August and is the second such installation, located 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 below the earth. This is the safest way of providing help to our wounded military personnel. It also ensures healthcare workers protected,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring amputations, or serious stomach wounds. Some patients can walk. Almost all are the victims of Russian first-person view (FPV) drones, which drop explosives with deadly accuracy. “90% of our patients are from FPVs. We see few gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating wounded soldiers in eastern Ukraine.

During one day recently, a group of three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a minor wound in his leg. “War is horrific. The guy beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the settlement is demolished. We see drones everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days in a forest area close to Pokrovsk, which Russia has been trying to seize since last year. The only way to get to their position was by walking. All supplies came by drone: rations and drinking water. A week after he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view drone ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, said a drone blast had left him with concussion. “My position was in a dugout. Suddenly it became black. I lost sensation anything or any sound,” he explained. “I think I was fortunate to remain alive. A relative has been killed. There are ongoing detonations.” A builder employed in Lithuania, Filipchuk noted he had returned to his homeland and volunteered to serve days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff placed him on a bed, took off a bloody dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Our forces must protect our nation,” he said.

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

Since 2022, enemy forces has consistently targeted medical centers, clinics, obstetric units and ambulances. Per human rights groups, 261 medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, soil and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm projectiles and even three 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which financed the construction, plans to build 20 facilities in total. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “critically important for preserving the lives of our armed forces and supporting troops on the frontline.” The company referred to the project as the “most ambitious and demanding” it had implemented since the enemy's invasion.

An example of the facility's operating theatres.

Holovashchenko, said some wounded soldiers had to wait hours or even multiple days before they could be transported due to the threat of aerial attacks. “Our facility received a pair of severely injured patients who arrived at 3am. It was necessary to perform a double amputation on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic operations? “I’ve been healthcare for two decades. You have to concentrate,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked under a shrub. He and the other soldiers were taken to the urban center of a major city for further treatment. The underground hospital staff took a break. The hospital’s ginger cat, the mascot, walked up to the entrance to greet the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”