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Sparse trees hide the entryway. One descending timber tunnel leads down to a brightly lit reception area. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus shelves stocked of healthcare supplies, medications and neat piles of extra garments. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of Russian spy drones as they weave in the air above.

Hospital staff at an underground medical center observe a monitor displaying Russian kamikaze and surveillance drones in the area.

This is the nation's secret below-ground hospital. This center began operations in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. This is the most secure method of delivering care to our wounded military personnel. It also ensures medical personnel safe,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a each day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Others can walk. Almost all are the victims of enemy first-person view (FPV) drones, which release grenades with deadly accuracy. “90% of our cases are from FPVs. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the doctor said.

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

On one afternoon recently, a group of three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his limb. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

The soldier said his squad spent over a month in a wooded zone close to Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their location was by walking. Necessary provisions arrived by drone: rations and drinking water. Seven days after he was injured, he walked five kilometers (roughly three miles), requiring three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV aerial device caused a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been killed. There are continuous detonations.” A builder working in a neighboring country, Filipchuk said he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a stained dressing and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a mobile phone to call his family member. “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. That will take a several months. Subsequently, to return to my military group. Our forces must defend our nation,” he said.

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

Since 2022, Russia has repeatedly attacked hospitals, clinics, maternity wards and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in nearly 2,000 attacks. The underground facility is built from multiple reinforced shelters, with timber beams, soil and granular material laid on top reaching the surface. It can withstand direct hits from 152mm projectiles and even three 8kg explosive devices dropped by drone.

A major steel and mining company, which funded the construction, plans to erect twenty facilities in total. The head of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “vitally essential for preserving the lives of our military and assisting defenders on the frontline.” The company described the initiative as the “largest-scale and challenging” it had implemented since the enemy's military offensive.

One of the centre’s surgical rooms.

Holovashchenko, said certain injured personnel had to endure delays many hours or even days before they could be evacuated due to the threat of air assaults. “We had two severely injured patients who arrived at the early hours. It was necessary to carry out a double amputation on one of them. His bleeding control device had been applied for so long there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants transported the soldier through the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other soldiers were taken to the city of a major city for additional medical care. The underground medical team paused for rest. The facility's orange feline, Vasilevs, walked up to the entrance to greet the next arrivals. “We are open around the clock,” the surgeon stated. “It doesn’t stop.”