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Sparse trees hide the entryway. A descending timber passageway descends to a brightly lit reception area. There is a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. Plus cabinets full of healthcare supplies, drugs and organized stacks 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 enemy surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground medical center look at a monitor displaying Russian kamikaze and reconnaissance drones in the region.

Welcome to Ukraine’s covert below-ground medical facility. This center opened in the eighth month and is the second such installation, located in eastern Ukraine close to the combat zone and the city of a key location in Donetsk oblast. “Our facility sits six meters under the ground. It’s the most secure method of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles 30-40 casualties a day. Cases differ widely. Some have devastating limb trauma requiring amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy FPV drones, which release explosives with lethal precision. “90% of our cases are from first-person view drones. We encounter few bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Major the senior surgeon at the subterranean installation for caring for wounded soldiers in the eastern region.

On one afternoon recently, a group of three military members limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his leg. “War is horrific. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the enemy forces dropped a another grenade on him.” He added: “Everything in the village is destroyed. There are UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi said his unit spent over a month in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to get to their position was on foot. Necessary provisions came by drone: food and water. Seven days after he was injured, he walked 5km (roughly three miles), requiring three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic checked his vital signs. Following care, a medical attendant gave him new non-military attire: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, 28, stated a first-person view aerial device caused a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a drone blast had left him with a head injury. “I was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he said. “I think I was fortunate to survive. A relative has been lost. There are continuous detonations.” A construction worker employed in Lithuania, he said he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a medical cot, took off a stained dressing and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a cellphone to ring his sister. “A piece of mortar hit 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 military group. Our forces must protect our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the back by a fragment of mortar.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, obstetric units and ambulances. Per international monitors, over two hundred health workers have been killed in almost two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, earth and sand placed above up to the surface. It can withstand direct hits from large-caliber artillery shells and even three 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, plans to build twenty facilities in total. A senior official of the nation's national security council and ex- defence minister, Rustem Umerov, said they would be “vitally essential for saving the lives of our armed forces and assisting defenders on the frontline.” The company described the initiative as the “most ambitious and demanding” it had undertaken after Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained certain injured soldiers had to wait hours or even days before they could be transported because of the danger of aerial attacks. “Our facility received a pair of critically ill patients who came at 3am. I had to perform a removal of both limbs on one of them. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “My career in medicine for 20 years. One must concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the passage and into an ambulance. The vehicle was stationed beneath a shrub. He and the two other military members were taken to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to await the incoming patients. “We are open around the clock,” Holovashchenko stated. “It doesn’t stop.”