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Sparse foliage hide the entryway. A descending wooden tunnel descends to a brightly lit welcome zone. There is a surgery unit, outfitted with beds, cardiac monitors and ventilators. And cabinets full of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a washing machine and kettle, doctors monitor a screen. The screen reveals the movements of enemy spy drones as they weave in the air above.

Medical personnel at an underground medical center observe a screen showing Russian suicide and reconnaissance drones in the area.

This is the nation's covert below-ground medical facility. The facility began operations in August and is the second of its kind, situated in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. This is the most secure way of delivering care to our wounded soldiers. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 patients a day. Cases differ widely. Some have devastating limb trauma requiring amputations, or serious abdominal injuries. Some patients can walk. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with deadly precision. “90% of our cases are from FPVs. We encounter minimal bullet injuries. This is an era of unmanned aircraft and a new type of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded soldiers in the eastern region.

During one afternoon recently, three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV blast had ripped a minor wound in his leg. “War is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He continued: “All structures in the village is demolished. There are UAVs all around and bodies. Ours and the enemy's.”

The soldier said his squad endured over a month in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their position was on foot. Necessary provisions came by drone: rations and water. Seven days after he was injured, he traveled 5km (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. Following care, a nurse provided him with new civilian clothes: a shirt and a set of pale denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “My position was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. There are ongoing explosions.” A construction worker employed in Lithuania, Filipchuk noted he had come back to his homeland and enlisted to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a medical cot, took off a bloody dressing 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. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a several months. Subsequently, to return to my military group. Someone has to protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was injured in the back by a fragment of artillery shell.

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. The underground facility is constructed from four reinforced shelters, with wooden supports, soil and sand laid on top up to the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple 8kg TNT charges dropped by aerial means.

A major industrial group, which funded the construction, plans to build 20 facilities in total. The head of the nation's national security council and ex- military leader, Rustem Umerov, declared they would be “vitally important for preserving the survival of our armed forces and supporting defenders on the battlefront.” The company described the initiative as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained certain wounded personnel had to wait hours or even days before they could be evacuated because of the danger of air assaults. “We had a pair of critically ill casualties who arrived at 3am. It was necessary to carry out a double amputation on a patient. His tourniquet had been on for so long there was no other option.” What is his method with severe surgeries? “My career in healthcare for two decades. You have to concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was stationed under a bush. He and the two other military members were transferred to the urban center of a major city for additional medical care. The subterranean medical team took a break. The facility's orange feline, Vasilevs, padded up to the entrance to greet the next arrivals. “We are open around the clock,” Holovashchenko stated. “It doesn’t stop.”