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Scrubby trees hide the entrance. A descending timber tunnel descends to a well-illuminated welcome zone. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and ventilators. And cabinets stocked of medical equipment, medications and organized stacks of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the sky above.

Medical staff at an underground medical center look at a monitor displaying Russian suicide and surveillance UAVs in the area.

This is Ukraine’s secret below-ground medical facility. This center opened in August and is the second such installation, located in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in the Donetsk region. “We are 6 metres below the earth. It’s the most secure way of delivering care to our injured soldiers. It also ensures medical personnel protected,” stated the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point treats thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating amputations, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of Russian FPV aerial devices, which drop explosives with deadly precision. “Ninety per cent of our cases are from first-person view drones. We encounter minimal bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the doctor said.

Maj the senior surgeon at the underground installation for treating wounded troops in the eastern region.

On one afternoon last week, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV blast had ripped a minor wound in his leg. “Conflict is terrible. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians dropped a another explosive on him.” He continued: “All structures in the settlement is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

The soldier explained his squad spent over a month in a wooded zone 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. All supplies came by quadcopter: food and water. Seven days following he was hurt, he traveled five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his physical condition. Following care, a nurse gave him new non-military attire: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, stated a FPV drone ripped a minor injury in his leg.

Another patient, 38-year-old a serviceman, said a UAV explosion had left him with concussion. “My position was in a trench shelter. It suddenly became black. I couldn’t feel anything or hear anything,” he said. “I think I was fortunate to remain alive. My cousin has been killed. There are ongoing detonations.” A builder employed in a neighboring country, he said he had returned to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff laid him on a medical cot, removed a bloody dressing and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A fragment of artillery hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a few months. Subsequently, to return to my military group. Someone has to protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 medical personnel have been killed in nearly two thousand attacks. The underground facility is built from multiple steel bunkers, with wooden supports, earth and sand laid on top up to ground level. It is designed to resist direct hits from large-caliber artillery shells and even multiple 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the construction, plans to build twenty facilities in total. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “critically essential for preserving the lives of our military and assisting defenders on the battlefront.” The organization described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

One of the facility's operating theatres.

The surgeon, said some injured soldiers had to wait hours or even days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill patients who arrived at the early hours. I had to perform a double amputation on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for two decades. One must focus,” he said.

Orderlies transported Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. He and the two other soldiers were taken to the city of a major city for additional medical care. The subterranean medical team took a break. The facility's ginger cat, Vasilevs, padded up to the entrance to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”