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Scrubby trees hide the entryway. A descending timber tunnel descends to a brightly lit welcome zone. Inside lies a operating ward, equipped with gurneys, heart rate sensors and breathing machines. And shelves full of healthcare supplies, drugs and neat piles of extra garments. Within a staff room with a washing machine and kettle, doctors keep an eye on a display. It shows the movements of Russian spy drones as they zigzag in the sky above.

Medical personnel at an subterranean medical center observe a monitor displaying Russian suicide and surveillance drones in the area.

Welcome to Ukraine’s secret below-ground medical facility. This center began operations in August and is the second of its kind, located in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres below the earth. It’s the safest way of delivering care to our wounded soldiers. It also ensures medical personnel protected,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats thirty to forty casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring amputations, or serious abdominal injuries. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which release explosives with deadly precision. “90% of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an age of drones and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for treating injured troops in the eastern region.

On one afternoon recently, a group of three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a small hole in his leg. “War is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He continued: “Everything in the settlement is demolished. We see UAVs all around and bodies. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days in a wooded zone near Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their position was on foot. All supplies arrived by quadcopter: rations and water. A week after he was hurt, he traveled five kilometers (roughly three miles), taking three hours, to where an military transport was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a nurse gave him fresh non-military attire: a T-shirt and a pair of light-colored jeans.

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

A different casualty, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I think I was lucky to survive. My cousin has been lost. There are ongoing explosions.” A construction worker working in a neighboring country, he said he had come back to Ukraine and volunteered to fight days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as doctors placed him on a medical cot, took off a stained bandage and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To get better. That will take a few months. Subsequently, to return to my unit. Someone has to protect our country,” he affirmed.

Medical staff care for the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently targeted medical centers, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred health workers have been killed in almost two thousand assaults. The underground facility is constructed from four steel bunkers, with timber beams, soil and granular material placed above reaching the surface. It can withstand direct hits from large-caliber projectiles and even three 8kg explosive devices dropped by drone.

A major steel and mining company, which funded the construction, intends to build twenty facilities in all. A senior official of Ukraine’s security agency and former military leader, the official, declared they would be “vitally essential for preserving the lives of our military and assisting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

One of the facility's operating theatres.

Holovashchenko, explained some injured personnel had to wait hours or even days before they could be evacuated due to the danger of aerial attacks. “We had two severely injured patients who arrived at 3am. I had to carry out a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no other option.” How did he cope with traumatic operations? “I’ve been medicine for two decades. You have to focus,” he said.

Orderlies transported Mykolaichuk up the tunnel and into an ambulance. The vehicle was stationed under a bush. The patient and the two other military members were taken to the city of Dnipro for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, the mascot, padded toward the entrance to await the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “It doesn’t stop.”