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Scrubby trees conceal the entrance. A sloping wooden tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus shelves full of medical equipment, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, physicians monitor a display. It shows the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center look at a monitor displaying enemy kamikaze and reconnaissance UAVs in the region.

This is Ukraine’s covert below-ground medical facility. The facility began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the most secure way of providing help to our wounded soldiers. And it keeps medical personnel protected,” said the facility's surgeon, Major the chief surgeon.

This medical station treats thirty to forty patients a each day. Cases differ widely. Some have catastrophic leg injuries necessitating amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of enemy FPV aerial devices, which release grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a different kind of war,” the doctor said.

Major the senior surgeon at the underground facility for caring for injured soldiers in the eastern region.

During one day last week, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an FPV explosion had ripped a small hole in his limb. “Conflict is horrific. My comrade next to me, Vasyl, was killed,” he said. “He fell down. Then the enemy forces released a another grenade on him.” He continued: “All structures in the village is demolished. There are UAVs all around and bodies. Our side's and the enemy's.”

The soldier said his unit endured 43 days in a wooded zone close to the city, which Russia has been trying to seize since last year. The only way to get to their location was on foot. All supplies came by quadcopter: rations and water. Seven days after he was injured, he walked 5km (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a FPV aerial device caused a minor injury in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been lost. We face ongoing detonations.” A builder employed in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to serve shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as doctors laid him on a medical cot, took off a stained dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A fragment of artillery hit me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. Subsequently, to return to my unit. Someone must protect our country,” he affirmed.

Doctors treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, Russia has consistently targeted medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and granular material laid on top reaching the surface. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram explosive devices dropped by drone.

A major industrial group, which funded the construction, plans to erect twenty units in total. A senior official of the nation's national security council and ex- defence minister, the official, declared they would be “vitally important for preserving the survival of our armed forces and supporting troops on the battlefront.” The organization referred to the project as the “largest-scale and demanding” it had implemented after the enemy's invasion.

An example of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to endure delays many hours or even days before they could be transported because of the threat of aerial attacks. “Our facility received a pair of severely injured casualties who arrived at the early hours. It was necessary to carry out a double amputation on a patient. His bleeding control device had been on for so long there was no alternative.” What is his method with severe operations? “I’ve been healthcare for two decades. One must focus,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. He and the two other military members were transferred to the urban center of a major city for further treatment. The subterranean medical team paused for rest. The hospital’s ginger cat, the mascot, padded toward the entrance to greet the incoming patients. “Our facility operates open 24 hours a day,” the surgeon said. “The work is continuous.”