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Sparse foliage hide the entryway. One descending timber passageway leads down to a well-illuminated reception area. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves stocked of medical equipment, drugs and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the movements of enemy spy drones as they weave in the air above.

Medical staff at an subterranean medical center look at a monitor displaying Russian kamikaze and surveillance drones in the area.

This is Ukraine’s covert underground medical facility. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of a key location in Donetsk oblast. “We are six meters under the ground. It’s the safest method of delivering care to our injured soldiers. It also ensures medical personnel safe,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles thirty to forty casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our patients are from first-person view drones. We see minimal bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the subterranean facility for treating injured soldiers in the eastern region.

During one afternoon last week, three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had torn a minor wound in his leg. “War is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “All structures in the village is destroyed. There are drones everywhere and bodies. Our side's and theirs.”

The soldier said his unit spent over a month in a forest area near the city, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies arrived by drone: food and drinking water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff assessed his physical condition. After treatment, a medical attendant gave him new non-military attire: a T-shirt and a pair of pale denim trousers.

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

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly became black. I couldn’t feel anything or any sound,” he said. “I think I was fortunate to survive. My cousin has been killed. We face continuous explosions.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a bed, took off a bloody dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to call his sister. “A piece of mortar struck me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a several months. After that, to go back to my military group. Our forces must defend our country,” he said.

Doctors treat the wounded soldier, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently attacked medical centers, clinics, obstetric units and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in nearly 2,000 attacks. The underground facility is built from multiple steel bunkers, with wooden supports, earth and sand placed above up to ground level. It can withstand impacts from 152mm projectiles and even multiple 8kg explosive devices dropped by aerial means.

A major steel and mining company, which funded the construction, plans to erect 20 units in total. The head of Ukraine’s national security council and former defence minister, the official, said they would be “vitally important for preserving the survival of our armed forces and assisting troops on the battlefront.” The company referred to the project as the “most ambitious and challenging” it had undertaken since Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained some injured personnel had to endure delays hours or even multiple days before they could be evacuated because of the danger of air assaults. “We had a pair of critically ill patients who came at 3am. I had to perform a double amputation on a patient. His tourniquet had been applied for such an extended period there was no other option.” What is his method with traumatic surgeries? “I’ve been medicine for 20 years. One must concentrate,” he said.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The vehicle was parked under a bush. The patient and the two other soldiers were taken to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded up to the entrance to greet the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko said. “The work is continuous.”