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Sparse foliage conceal the entrance. A descending timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. Plus cabinets full of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, physicians monitor a display. It shows the flight patterns of Russian spy drones as they zigzag in the air above.

Hospital personnel at an subterranean medical center look at a monitor showing enemy kamikaze and reconnaissance drones in the region.

Welcome to the nation's secret underground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure method of providing help to our wounded military personnel. It also ensures medical personnel protected,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats thirty to forty casualties a day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Others can move on their own. Almost all are the victims of enemy first-person view (FPV) aerial devices, which release explosives with lethal accuracy. “90% of our cases are from first-person view drones. We encounter minimal bullet injuries. This is an era of drones and a different kind of war,” the surgeon said.

Major the senior surgeon at the subterranean facility for caring for wounded troops in the eastern region.

During one day last week, three military members limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a small hole in his leg. “Conflict is horrific. The guy next to me, Vasyl, was killed,” he said. “He fell down. Then the enemy forces dropped a second explosive on him.” He added: “All structures in the settlement is demolished. There are drones all around and casualties. Our side's and theirs.”

Dvorskyi said his unit endured 43 days in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was on foot. Necessary provisions arrived by quadcopter: rations and water. Seven days after he was hurt, he walked 5km (about 3 miles), requiring several hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a set of pale jeans.

The soldier, twenty-eight, said a FPV drone caused a small hole in his leg.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he said. “I think I was fortunate to remain alive. My cousin has been killed. There are continuous detonations.” A construction worker working in a neighboring country, he noted he had come back to his homeland and enlisted to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as doctors laid him on a medical cot, removed a bloody dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to go back to my unit. Our forces must protect our country,” he affirmed.

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

Since 2022, enemy forces has repeatedly targeted medical centers, clinics, obstetric units and ambulances. Per human rights groups, over two hundred medical personnel have been killed in nearly 2,000 assaults. This subterranean hospital is built from four reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram explosive devices released by drone.

A major industrial group, which financed the building, intends to build twenty facilities in all. A senior official of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “critically essential for preserving the lives of our armed forces and assisting defenders on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had undertaken after Russia’s military offensive.

One of the facility's operating theatres.

The surgeon, explained certain wounded soldiers had to wait hours or even multiple days before they could be evacuated because of the threat of air assaults. “Our facility received a pair of severely injured casualties who arrived at the early hours. It was necessary to carry out a double amputation on a patient. The soldier's tourniquet had been applied for such an extended period there was no other option.” What is his method with severe operations? “My career in medicine for 20 years. You have to focus,” he remarked.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The vehicle was parked under a bush. He and the other military members were transferred to the city of Dnipro for further treatment. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded toward the doorway to await the incoming patients. “We are open around the clock,” the surgeon stated. “The work is continuous.”