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Sparse foliage conceal the entryway. A sloping timber tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, equipped with gurneys, heart rate sensors and breathing machines. Plus shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a washing machine and kettle, doctors keep an eye on a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Hospital personnel at an subterranean medical center look at a screen displaying enemy kamikaze and surveillance UAVs in the area.

This is Ukraine’s secret underground medical facility. This center 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 the Donetsk region. “We are 6 metres under the ground. It’s the safest method of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop explosives with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal gunshot wounds. It’s an era of drones and a different kind of war,” the surgeon said.

Major Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in eastern Ukraine.

On one day last week, three military members limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He continued: “Everything in the settlement is demolished. We see UAVs everywhere and bodies. Our side's and theirs.”

The soldier explained his unit spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies came by drone: food and water. A week after he was injured, he walked five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his vital signs. After treatment, a medical attendant gave him fresh civilian clothes: a T-shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, said a FPV drone caused a small hole in his leg.

A different casualty, 38-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or any sound,” he explained. “I believe I was lucky to remain alive. A relative has been lost. There are continuous explosions.” A construction worker employed in a neighboring country, he said he had come back to his homeland and enlisted to serve shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff placed him on a medical cot, took off a bloody dressing and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his sister. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. Subsequently, to return to my unit. Someone must defend our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the dorsal area by a piece of artillery shell.

Since 2022, Russia has consistently targeted hospitals, clinics, maternity wards and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost two thousand assaults. The underground facility is built from multiple steel bunkers, with wooden supports, soil and granular material placed above reaching ground level. It can withstand impacts from large-caliber artillery shells and even three eight-kilogram explosive devices released by drone.

A major steel and mining company, which financed the building, plans to build twenty facilities in all. A senior official of Ukraine’s security agency and ex- military leader, Rustem Umerov, declared they would be “vitally essential for preserving the lives of our military and supporting troops on the battlefront.” The organization described the project as the “most ambitious and demanding” it had undertaken after the enemy's invasion.

One of the centre’s surgical rooms.

The surgeon, said some injured soldiers had to endure delays hours or even multiple days before they could be evacuated due to the threat of air assaults. “We had two critically ill casualties who came at the early hours. I had to carry out a removal of both limbs on one of them. His tourniquet had been on for so long there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for two decades. You have to concentrate,” he remarked.

Orderlies transported Mykolaichuk up the tunnel and into an emergency vehicle. The transport was stationed under a bush. He and the two other military members were transferred to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, the mascot, padded up to the entrance to greet the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko said. “The work is continuous.”