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Sparse foliage hide the entrance. One sloping wooden passageway leads down to a brightly lit welcome zone. There is a operating ward, outfitted with beds, heart rate sensors and breathing machines. Plus cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a break area with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the flight patterns of enemy spy drones as they weave in the air above.

Medical personnel at an underground medical center observe a monitor displaying Russian suicide and reconnaissance UAVs in the area.

This is the nation's covert underground medical facility. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters under the earth. It’s the safest method of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Others can walk. The vast majority are the victims of Russian first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the subterranean installation for treating wounded troops in eastern Ukraine.

On one afternoon recently, a group of three military members walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a second grenade on him.” He continued: “All structures in the village is destroyed. We see drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad spent 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. Necessary provisions arrived by drone: rations and drinking water. Seven days after he was injured, he walked five kilometers (about 3 miles), requiring three hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff checked his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. There are ongoing detonations.” A builder working in Lithuania, Filipchuk said he had returned to his homeland and enlisted to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, removed a bloody bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to call his family member. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Someone must defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has repeatedly attacked medical centers, clinics, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from multiple reinforced shelters, with timber beams, soil and granular material placed above up to ground level. It can withstand direct hits from large-caliber projectiles and even three 8kg explosive devices released by aerial means.

A major steel and mining company, which financed the building, intends to build twenty facilities in total. A senior official of the nation's security agency and ex- military leader, the official, declared they would be “critically essential for saving the lives of our armed forces and assisting defenders on the battlefront.” The organization described the initiative as the “largest-scale and challenging” it had implemented since Russia’s invasion.

One of the facility's surgical rooms.

Holovashchenko, said some wounded personnel had to wait hours or even days before they could be transported due to the threat of air assaults. “Our facility received a pair of critically ill casualties who came at 3am. I had to perform a removal of both limbs 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 healthcare for two decades. You have to focus,” he remarked.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was stationed beneath a bush. The patient and the two other soldiers were transferred to the city of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked up to the entrance to await the incoming patients. “Our facility operates active around the clock,” Holovashchenko stated. “It doesn’t stop.”