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Sparse trees hide the entrance. One descending timber passageway descends to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, doctors monitor a display. It shows the movements of Russian surveillance UAVs as they zigzag in the sky above.

Medical personnel at an underground hospital look at a screen showing enemy suicide and surveillance UAVs in the area.

Welcome to Ukraine’s covert underground medical facility. The facility opened in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “We are 6 metres below the earth. This is the most secure way of delivering care to our injured military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 patients a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma necessitating amputations, or serious stomach wounds. Some patients can walk. The vast majority are the victims of Russian FPV drones, which release explosives with deadly accuracy. “90% of our patients are from FPVs. We see minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the doctor said.

Maj the senior surgeon at the underground facility for caring for injured soldiers in eastern Ukraine.

During one afternoon recently, three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a small hole in his leg. “War is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a second explosive on him.” He continued: “Everything in the settlement is demolished. We see UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi said his unit spent 43 days in a wooded zone near the city, which enemy forces has been attempting to capture for many months. Sole access to get to their position was by walking. All supplies came by quadcopter: food and water. Seven days after he was injured, he walked five kilometers (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him new non-military attire: a T-shirt and a pair of pale jeans.

The soldier, 28, stated a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I think I was fortunate to survive. My cousin has been killed. We face continuous detonations.” A builder working in a neighboring country, Filipchuk noted he had returned to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as doctors laid him on a medical cot, removed a stained bandage and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A piece of artillery hit me. The cause was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. That will take a several months. Subsequently, to go back to my military group. Someone must protect our country,” he said.

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

Over the past years, enemy forces has consistently targeted medical centers, clinics, obstetric units and ambulances. Per international monitors, over two hundred health workers have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and sand placed above reaching the surface. It can withstand direct hits from large-caliber projectiles and even three eight-kilogram TNT charges released by drone.

A major industrial group, which financed the building, plans to erect 20 units in total. A senior official of Ukraine’s security agency and former defence minister, Rustem Umerov, said they would be “vitally essential for saving the survival of our armed forces and assisting defenders on the battlefront.” The organization referred to the project as the “largest-scale and demanding” it had undertaken since the enemy's military offensive.

An example of the facility's surgical rooms.

The surgeon, explained some wounded personnel had to endure delays many hours or even multiple days before they could be evacuated due to the threat of air assaults. “Our facility received two critically ill casualties who arrived at 3am. I had to carry out a double amputation on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with severe surgeries? “I’ve been healthcare for 20 years. You have to focus,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked beneath a bush. He and the other soldiers were transferred to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The facility's orange feline, the mascot, walked up to the doorway to await the next arrivals. “Our facility operates active around the clock,” the surgeon said. “It doesn’t stop.”