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Scrubby trees hide the entryway. A sloping wooden passageway descends to a brightly lit reception area. There is a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. And shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a washing machine and kettle, doctors keep an eye on a display. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital look at a screen displaying Russian kamikaze and reconnaissance UAVs in the region.

This is Ukraine’s secret below-ground medical facility. This center began operations in the eighth month and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “We are six meters under the ground. It’s the most secure way of delivering care to our injured military personnel. And it keeps medical personnel protected,” said the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Their conditions vary. Some have catastrophic limb trauma requiring amputations, or severe abdominal injuries. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which release explosives with deadly accuracy. “90% of our cases are from first-person view drones. We see few gunshot wounds. This is an age of unmanned aircraft and a different kind of conflict,” the surgeon said.

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

During one day last week, a group of three military members limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his limb. “Conflict is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the Russians dropped a second grenade on him.” He continued: “Everything in the village is destroyed. We see drones everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. The only way to reach their position was by walking. All supplies came by drone: rations and water. A week after he was injured, he traveled five kilometers (about 3 miles), taking three hours, to where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with fresh non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, stated a FPV aerial device ripped a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. It suddenly became black. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. A relative has been killed. We face ongoing detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as doctors laid him on a bed, took off a stained dressing and treated his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a mobile phone to call his sister. “A piece of artillery hit me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. That will take a few months. After that, to go back to my military group. Someone must defend our country,” he affirmed.

Doctors treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and ambulances. Per human rights groups, 261 health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from four reinforced shelters, with wooden supports, earth and sand placed above up to the surface. It is designed to resist impacts from large-caliber projectiles and even three eight-kilogram explosive devices dropped by aerial means.

The Ukrainian industrial group, which financed the construction, intends to erect twenty units in total. The head of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “critically important for preserving the lives of our armed forces and assisting defenders on the battlefront.” The company referred to the project as the “largest-scale and demanding” it had implemented after the enemy's invasion.

An example of the facility's operating theatres.

The surgeon, explained certain wounded personnel had to endure delays many hours or even days before they could be evacuated due to the danger of aerial attacks. “We had a pair of critically ill casualties who arrived at 3am. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been on for so long there was no other option.” What is his method with severe surgeries? “My career in medicine for two decades. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a bush. He and the two other military members were taken to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, Vasilevs, padded toward the doorway to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”