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Scrubby trees hide the entrance. One sloping wooden passageway descends to a well-illuminated reception area. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, medications and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital observe a monitor displaying Russian suicide and reconnaissance drones in the region.

This is the nation's covert below-ground medical facility. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country close to the frontline and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters under the ground. It’s the safest method of delivering care to our injured military personnel. And it keeps medical personnel protected,” said the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Some have devastating leg injuries requiring amputations, or severe abdominal injuries. Others can move on their own. Almost all are the victims of enemy FPV aerial devices, which drop grenades with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of war,” the doctor explained.

Maj the senior surgeon at the subterranean facility for treating wounded soldiers in the eastern region.

On one afternoon recently, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, said an FPV explosion had ripped a minor wound in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was killed,” he stated. “He collapsed. Then the Russians released a second explosive on him.” He continued: “All structures in the village is destroyed. We see drones all around and bodies. Ours and theirs.”

The soldier explained his squad spent over a month in a forest area close to the city, which enemy forces has been trying to seize for many months. Sole access to reach their location was on foot. Necessary provisions came by drone: rations and water. Seven days following he was injured, he walked five kilometers (roughly three miles), taking several hours, to a point where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse provided him with fresh non-military attire: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, 28, said a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he explained. “I believe I was fortunate to survive. My cousin has been lost. There are continuous detonations.” A builder employed in Lithuania, he noted he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, removed a stained dressing and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of artillery struck me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To get better. This may require a several months. After that, to go back to my unit. Our forces has to protect our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Since 2022, enemy forces has consistently targeted hospitals, clinics, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost two thousand attacks. The underground facility is constructed from multiple steel bunkers, with timber beams, soil and sand placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even multiple eight-kilogram TNT charges dropped by drone.

A major industrial group, which financed the construction, plans to erect twenty facilities in total. A senior official of the nation's national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our military and supporting troops on the frontline.” The company referred to the project as the “largest-scale and demanding” it had undertaken since Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, explained some wounded personnel had to wait hours or even multiple days before they could be transported because of the threat of air assaults. “We had a pair of critically ill casualties who came at the early hours. I had to carry out a double amputation on a patient. The soldier's 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 20 years. You have to concentrate,” he said.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The transport was parked under a shrub. He and the two other military members were transferred to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, the mascot, padded toward the doorway to greet the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”