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Scrubby trees conceal the entryway. One descending timber tunnel leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And cabinets full of medical equipment, medications and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the movements of Russian spy drones as they zigzag in the air above.

Medical staff at an underground hospital look at a monitor displaying Russian suicide and surveillance drones in the area.

Welcome to the nation's covert below-ground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the ground. This is the safest method of delivering care to our injured soldiers. It also ensures medical personnel protected,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have devastating leg injuries necessitating amputations, or serious stomach wounds. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj the senior surgeon at the underground installation for caring for wounded soldiers in eastern Ukraine.

During one afternoon last week, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a small hole in his limb. “Conflict is terrible. The guy next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the Russians released a second grenade on him.” He continued: “Everything in the settlement is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

The soldier explained his squad endured 43 days in a forest area near the city, which Russia has been trying to seize since last year. Sole access to get to their location was on foot. All supplies arrived by drone: rations and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale denim trousers.

The soldier, 28, stated a FPV drone caused a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had left him with concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or any sound,” he explained. “I think I was fortunate to remain alive. A relative has been lost. We face continuous detonations.” A builder working in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the back. He expressed pain as doctors placed him on a bed, removed a stained dressing and cleaned his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to return to my military group. Someone has to protect our country,” he affirmed.

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

Since 2022, Russia has repeatedly attacked hospitals, health facilities, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in almost 2,000 assaults. The underground facility is constructed from multiple steel bunkers, with wooden supports, soil and sand placed above up to ground level. It can withstand direct hits from large-caliber projectiles and even three 8kg TNT charges dropped by aerial means.

A major steel and mining company, which funded the construction, plans to erect twenty units in total. The head of the nation's national security council and ex- defence minister, Rustem Umerov, declared they would be “critically essential for saving the survival of our armed forces and supporting defenders on the battlefront.” The organization described the project as the “largest-scale and demanding” it had implemented since Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, explained certain wounded personnel had to endure delays hours or even days before they could be transported because of the threat of aerial attacks. “Our facility received a pair of critically ill casualties who arrived at 3am. I had to carry out 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 alternative.” What is his method with severe surgeries? “I’ve been medicine for 20 years. One must focus,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an ambulance. The transport was stationed under a shrub. He and the other soldiers were transferred to the urban center of a major city for additional medical care. The underground medical team took a break. The facility's orange feline, the mascot, walked up to the entrance to await the incoming patients. “We are active around the clock,” Holovashchenko said. “The work is continuous.”