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Scrubby trees conceal the entrance. One sloping timber tunnel leads down to a well-illuminated reception area. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And shelves full of healthcare supplies, medications and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, doctors monitor a display. It shows the movements of enemy surveillance UAVs as they zigzag in the sky above.

Hospital personnel at an underground medical center look at a monitor displaying enemy suicide and reconnaissance drones in the region.

This is Ukraine’s secret below-ground medical facility. The facility began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “We are six meters under the earth. This is the safest way of providing help to our wounded soldiers. And it keeps medical personnel safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Their conditions vary. Some have devastating limb trauma necessitating surgical removal, or severe stomach wounds. Others can move on their own. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “90% of our cases are from FPVs. We see few bullet injuries. This is an era of drones and a new type of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for caring for injured soldiers in eastern Ukraine.

On one day last week, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces released a second grenade on him.” He added: “Everything in the settlement is destroyed. We see drones all around and casualties. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a wooded zone near the city, which Russia has been trying to seize for many months. The only way to reach their location was on foot. All supplies arrived by drone: food and water. Seven days following he was injured, he traveled 5km (roughly three miles), taking several hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, stated a first-person view drone caused a minor injury in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “My position was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he said. “I think I was fortunate to survive. My cousin has been lost. There are ongoing detonations.” A construction worker working in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as medical staff placed him on a medical cot, took off a stained bandage and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a several months. Subsequently, to return to my unit. Our forces has to defend our nation,” he affirmed.

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

Since 2022, enemy forces has consistently targeted hospitals, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from multiple steel bunkers, with timber beams, earth and granular material laid on top reaching the surface. It can withstand direct hits from large-caliber projectiles and even three 8kg TNT charges released by drone.

A major steel and mining company, which financed the building, plans to erect 20 facilities in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the survival of our armed forces and supporting defenders on the frontline.” The company described the initiative as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s operating theatres.

The surgeon, explained certain injured soldiers had to endure delays many hours or even days before they could be evacuated due to the danger of air assaults. “Our facility received two critically ill patients who arrived at 3am. It was necessary to perform a double amputation on one of them. The soldier's tourniquet had been on for such an extended period there was no alternative.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. You have to focus,” he said.

Orderlies wheeled Mykolaichuk up the passage and into an ambulance. The vehicle was parked under a shrub. The patient and the two other soldiers were transferred to the urban center of Dnipro for further treatment. The underground medical team took a break. The facility's orange feline, Vasilevs, padded up to the doorway to await the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”