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Sparse trees conceal the entrance. One sloping timber tunnel descends to a brightly lit welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And shelves full of medical equipment, drugs and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, doctors monitor a display. It shows the movements of Russian spy drones as they weave in the sky above.

Hospital personnel at an subterranean medical center look at a screen displaying enemy suicide and surveillance UAVs in the area.

Welcome to Ukraine’s covert below-ground hospital. The facility opened in the eighth month and is the second such installation, located in the eastern part of the country close to the frontline and the urban area of a key location in the Donetsk region. “We are six meters under the ground. It’s the most secure way of providing help to our injured soldiers. It also ensures healthcare workers safe,” stated the facility's lead doctor, Major the chief surgeon.

The stabilisation point treats thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring amputations, or severe stomach wounds. Some patients can move on their own. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop grenades with deadly accuracy. “90% of our patients are from FPVs. We see few bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for treating injured soldiers in eastern Ukraine.

On one day last week, three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a small hole in his limb. “Conflict is horrific. My comrade next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a second explosive on him.” He continued: “All structures in the settlement is destroyed. There are UAVs all around and bodies. Ours and theirs.”

The soldier said his squad spent over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. All supplies came by quadcopter: rations and water. Seven days after he was hurt, he walked 5km (roughly three miles), taking three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a nurse gave him fresh non-military attire: a shirt and a set of pale denim trousers.

The soldier, 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, said a UAV explosion had resulted in concussion. “I was in a trench shelter. It suddenly went dark. I lost sensation anything or any sound,” he explained. “I believe I was lucky to survive. My cousin has been killed. There are continuous detonations.” A construction worker employed in Lithuania, he noted he had returned to his homeland and enlisted to fight days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as doctors placed him on a bed, removed a stained dressing and cleaned his recent shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of mortar hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to return to my military group. Our forces must defend our nation,” he affirmed.

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

Since 2022, Russia has consistently targeted hospitals, clinics, obstetric units and ambulances. According to international monitors, 261 health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg TNT charges released by drone.

A major steel and mining company, which funded the building, intends to erect 20 units in total. A senior official of Ukraine’s national security council and former defence minister, Rustem Umerov, said they would be “critically important for preserving the lives of our military and assisting defenders on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had implemented since the enemy's invasion.

An example of the centre’s operating theatres.

Holovashchenko, said certain wounded soldiers had to wait many hours or even days before they could be transported due to the danger of aerial attacks. “We had a pair of critically ill casualties who came at 3am. It was necessary to perform a removal of both limbs on a patient. His tourniquet had been applied for so long there was no other option.” How did he cope with traumatic surgeries? “My career in healthcare for two decades. You have to concentrate,” he said.

Medical assistants transported the soldier through the passage and into an emergency vehicle. The transport was stationed under a shrub. The patient and the two other soldiers were transferred to the city of a major city for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, walked toward the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”