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Sparse foliage conceal the entrance. One sloping wooden passageway descends to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus shelves full of medical equipment, drugs and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, doctors monitor a screen. It shows the movements of enemy surveillance UAVs as they weave in the air above.

Medical staff at an underground medical center observe a screen displaying Russian kamikaze and reconnaissance UAVs in the region.

Welcome to Ukraine’s secret underground medical facility. The facility began operations in August and is the second such installation, situated in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the earth. It’s the safest method of providing help to our injured soldiers. It also ensures healthcare workers protected,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring amputations, or severe stomach wounds. Others can walk. The vast majority are the casualties of Russian FPV aerial devices, which drop grenades with deadly precision. “90% of our patients are from first-person view drones. We encounter few bullet injuries. It’s an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj the senior surgeon at the underground installation for treating wounded troops in eastern Ukraine.

During one day recently, a group of three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone explosion had ripped a small hole 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 village is demolished. We see drones all around and bodies. Ours and theirs.”

Dvorskyi said his squad spent 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their position was by walking. All supplies came by quadcopter: rations and water. A week after he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a nurse gave him new non-military attire: a shirt and a pair of light-colored jeans.

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

A different casualty, 38-year-old a serviceman, said a drone blast had left him with concussion. “My position was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to survive. A relative has been lost. We face continuous detonations.” A construction worker working in a neighboring country, he said he had come back to his homeland and volunteered to serve days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as doctors placed him on a bed, took off a bloody bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a mobile phone to call his sister. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. This may require a several months. After that, to return to my unit. Our forces has to protect our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the back by a fragment of mortar.

Since 2022, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been killed in nearly two thousand attacks. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material placed above reaching ground level. It is designed to resist impacts from 152mm artillery shells and even multiple eight-kilogram explosive devices dropped by drone.

The Ukrainian industrial group, which funded the construction, intends to erect twenty facilities in all. The head of Ukraine’s national security council and former defence minister, Rustem Umerov, said they would be “critically important for preserving the survival of our armed forces and supporting defenders on the battlefront.” The company referred to the initiative as the “most ambitious and challenging” it had implemented since the enemy's military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said some injured personnel had to endure delays many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had a pair of severely injured patients who arrived at 3am. It was necessary to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no other option.” How did he cope with severe operations? “My career in healthcare for two decades. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked under a bush. He and the other soldiers were taken to the urban center of Dnipro for additional medical care. The subterranean hospital staff took a break. The facility's orange feline, the mascot, padded toward the entrance to await the incoming patients. “We are active around the clock,” the surgeon stated. “It doesn’t stop.”