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Sparse trees conceal the entrance. One sloping wooden tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. Plus cabinets full of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a washing machine and hot water heater, doctors keep an eye on a screen. It shows the flight patterns of Russian spy drones as they zigzag in the sky above.

Medical staff at an subterranean hospital observe a screen displaying Russian kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, located in the eastern part of the country not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits six meters under the ground. It’s the most secure way of delivering care to our injured soldiers. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or serious stomach wounds. Others can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which drop grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the surgeon said.

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

During one afternoon recently, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his limb. “Conflict is terrible. The guy next to me, a fellow soldier, was killed,” he said. “He collapsed. Then the Russians dropped a another explosive on him.” He added: “All structures in the village is demolished. There are UAVs all around and casualties. Ours and theirs.”

Dvorskyi said his squad endured over a month in a wooded zone near the city, which enemy forces has been attempting to capture for many months. Sole access to reach their location was by walking. All supplies came by drone: food and drinking water. Seven days after he was injured, he traveled five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his physical condition. Following care, a medical attendant gave him fresh non-military attire: a T-shirt and a set of light-colored jeans.

The soldier, 28, stated a first-person view drone caused a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it became black. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been killed. We face continuous detonations.” A builder employed in Lithuania, he noted he had come back to Ukraine and enlisted to fight days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors laid him on a medical cot, removed a bloody bandage and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to call his family member. “A piece of mortar struck me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to go back to my unit. Someone has to protect our country,” he affirmed.

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

Since 2022, Russia has consistently targeted medical centers, health facilities, obstetric units and ambulances. Per international monitors, over two hundred health workers have been killed in nearly 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and granular material placed above reaching ground level. It can withstand direct hits from large-caliber artillery shells and even three 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which funded the building, intends to build 20 facilities in total. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, declared they would be “critically important for saving the survival of our armed forces and supporting troops on the battlefront.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken after the enemy's invasion.

One of the centre’s operating theatres.

Holovashchenko, explained certain injured soldiers had to endure delays many hours or even days before they could be transported due to the threat of aerial attacks. “Our facility received a pair of critically ill patients who arrived at 3am. I had to perform a double amputation on one of them. The soldier's bleeding control device had been on for such an extended period there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was parked under a bush. He and the two other military members were transferred to the city of Dnipro for additional medical care. The underground hospital staff took a break. The facility's ginger cat, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”