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Scrubby trees conceal the entrance. A sloping wooden passageway descends to a brightly lit welcome zone. There is a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, drugs and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, doctors keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an subterranean medical center observe a monitor displaying enemy kamikaze and surveillance UAVs in the area.

Welcome to the nation's covert underground medical facility. The facility began operations 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 Donetsk oblast. “We are six meters under the earth. It’s the safest way of providing help to our wounded military personnel. And it keeps medical personnel safe,” said the facility's lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of Russian FPV aerial devices, which release explosives with deadly precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

On one day recently, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an FPV explosion had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second grenade on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi explained his unit endured over a month in a forest area near the city, which Russia has been attempting to capture since last year. The only way to get to their position was by walking. All supplies came by drone: food and water. A week after he was injured, he traveled five kilometers (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant provided him with new non-military attire: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, 28, stated a first-person view aerial device ripped a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation anything or hear anything,” he said. “I think I was lucky to remain alive. A relative has been killed. We face continuous detonations.” A builder working in Lithuania, he noted he had returned to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, took off a bloody bandage and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of mortar hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a few months. After that, to return to my unit. Someone must protect our country,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the dorsal area by a piece of mortar.

Since 2022, Russia has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, over two hundred medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, soil and sand placed above up to the surface. It is designed to resist direct hits from large-caliber projectiles and even three eight-kilogram TNT charges released by aerial means.

A major industrial group, which financed the building, plans to erect twenty units in all. A senior official of the nation's national security council and ex- military leader, the official, said they would be “vitally essential for preserving the survival of our armed forces and assisting defenders on the battlefront.” The organization described the project as the “most ambitious and challenging” it had implemented after the enemy's invasion.

An example of the centre’s surgical rooms.

The surgeon, said certain injured personnel had to endure delays many hours or even multiple days before they could be transported because of 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 on for such an extended period there was no other option.” What is his method with severe surgeries? “I’ve been healthcare for two decades. You have to focus,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an ambulance. The vehicle was stationed under a bush. The patient and the other soldiers were taken to the urban center of Dnipro for further treatment. The underground medical team took a break. The facility's ginger cat, Vasilevs, walked toward the doorway to await the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko said. “The work is continuous.”