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Scrubby trees hide the entryway. A sloping timber passageway leads down to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a washing machine and hot water heater, doctors keep an eye on a screen. It shows the movements of Russian spy drones as they zigzag in the sky above.

Medical staff at an subterranean hospital observe a screen showing Russian suicide and surveillance UAVs in the area.

Welcome to Ukraine’s covert below-ground medical facility. This center began operations in August and is the second of its kind, located in eastern Ukraine not far from the frontline and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the earth. It’s the most secure way of delivering care to our injured military personnel. It also ensures medical personnel safe,” stated the clinic’s surgeon, Major the chief surgeon.

This medical station handles thirty to forty patients a day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the victims of Russian FPV drones, which release explosives with deadly accuracy. “Ninety per cent 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 war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the underground installation for caring for wounded troops in eastern Ukraine.

On one afternoon recently, three soldiers limped into the facility. The most lightly injured, 28-year-old one soldier, said an FPV blast had torn a minor wound in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the Russians released a another explosive on him.” He continued: “Everything in the settlement is demolished. There are drones everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a forest area close to the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. Necessary provisions arrived by quadcopter: food and drinking water. Seven days after he was injured, he walked 5km (about 3 miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his physical condition. Following care, a medical attendant provided him with new civilian clothes: a shirt and a pair of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “My position was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he said. “I believe I was fortunate to survive. My cousin has been lost. There are ongoing explosions.” A builder employed in a neighboring country, he noted he had come back to his homeland and enlisted to fight days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a bed, removed a stained bandage and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a cellphone to call his family member. “A piece of artillery hit me. It was a ricochet. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to return to my military group. Someone must defend our country,” he said.

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

Since 2022, Russia has repeatedly targeted medical centers, clinics, obstetric units and ambulances. According to international monitors, 261 health workers have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It can withstand direct hits from large-caliber projectiles and even multiple 8kg explosive devices dropped by drone.

A major industrial group, which financed the building, plans to erect twenty units in all. A senior official of the nation's national security council and former defence minister, Rustem Umerov, declared they would be “critically important for preserving the survival of our military and assisting troops on the frontline.” The company described the project as the “largest-scale and challenging” it had implemented after the enemy's invasion.

One of the facility's operating theatres.

Holovashchenko, explained certain injured personnel had to wait many hours or even multiple days before they could be transported due to the danger of air assaults. “Our facility received two severely injured patients who arrived at 3am. I had to carry out a double amputation on one of them. His tourniquet had been applied for such an extended period there was no other option.” What is his method with traumatic operations? “My career in medicine for 20 years. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was parked beneath a shrub. He and the two other soldiers were transferred to the city of Dnipro for additional medical care. The underground hospital staff took a break. The facility's ginger cat, the mascot, padded toward the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko stated. “The work is continuous.”