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Sparse foliage hide the entryway. A descending timber passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus shelves full of medical equipment, medications and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, physicians keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the air above.

Hospital personnel at an underground medical center observe a screen displaying Russian kamikaze and reconnaissance drones in the region.

This is Ukraine’s covert underground medical facility. This center began operations in the eighth month and is the second of its kind, situated in the eastern part of the country close to the frontline and the city of Pokrovsk in Donetsk oblast. “We are six meters under the ground. This is the most secure way of delivering care to our wounded military personnel. It also ensures medical personnel protected,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point treats thirty to forty patients a each day. Their conditions vary. Some have devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of drones and a different kind of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for treating injured troops in eastern Ukraine.

On one day recently, a group of three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “War is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a second explosive on him.” He continued: “Everything in the village is demolished. There are UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit endured 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. The only way to reach their location was by walking. Necessary provisions came by drone: food and water. Seven days after he was hurt, he walked 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his physical condition. After treatment, a medical attendant gave him new civilian clothes: a shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device ripped a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had left him with a head injury. “My position was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to survive. A relative has been lost. We face ongoing explosions.” A construction worker working in Lithuania, Filipchuk noted he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a bed, took off a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of mortar struck me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. That will take a several months. Subsequently, to go back to my unit. Our forces has to protect our nation,” he said.

Doctors care for Taras Mykolaichuk, who was injured in the dorsal area by a piece of mortar.

Since 2022, Russia has repeatedly attacked hospitals, clinics, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. The underground facility is built from multiple steel bunkers, with wooden supports, soil and granular material laid on top reaching ground level. It can withstand impacts from large-caliber artillery shells and even three eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which funded the construction, plans to erect 20 units in total. A senior official of the nation's national security council and ex- military leader, Rustem Umerov, declared they would be “critically essential for saving the lives of our military and assisting troops on the battlefront.” The company referred to the initiative as the “largest-scale and demanding” it had implemented after the enemy's military offensive.

One of the centre’s operating theatres.

The surgeon, said certain wounded personnel had to endure delays many hours or even days before they could be transported due to the danger of air assaults. “We had a pair of severely injured casualties who came at 3am. It was necessary to perform a removal of both limbs on a patient. The soldier's tourniquet had been on for so long there was no other option.” What is his method with severe surgeries? “My career in healthcare for two decades. You have to concentrate,” he said.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. He and the other soldiers were taken to the city of Dnipro for additional medical care. The subterranean medical team paused for rest. The facility's ginger cat, Vasilevs, walked up to the entrance to await the next arrivals. “Our facility operates active around the clock,” the surgeon stated. “It doesn’t stop.”