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Sparse foliage hide the entryway. A sloping timber tunnel descends to a well-illuminated welcome zone. Inside lies a surgery unit, equipped with beds, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and organized stacks of spare clothes. Within a break area with a washing machine and hot water heater, doctors monitor a display. It shows the movements of Russian spy drones as they zigzag in the sky above.

Hospital staff at an underground medical center observe a screen showing Russian kamikaze and surveillance UAVs in the area.

Welcome to Ukraine’s secret below-ground hospital. This center opened in the eighth month and is the second such installation, situated in the eastern part of the country not far from the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the most secure method of delivering care to our injured military personnel. And it keeps healthcare workers safe,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point treats 30-40 casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring surgical removal, or serious stomach wounds. Some patients can walk. The vast majority are the casualties of Russian FPV aerial devices, which release explosives with lethal accuracy. “Ninety per cent of our patients are from FPVs. We encounter minimal bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the doctor said.

Major Oleksandr Holovashchenko at the underground facility for treating wounded troops in eastern Ukraine.

During one afternoon last week, a group of three military members limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his leg. “War is terrible. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the Russians released a second explosive on him.” He continued: “All structures in the village is demolished. We see UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit spent over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. All supplies came by quadcopter: rations and drinking water. A week following he was injured, he walked five kilometers (roughly three miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medic checked his physical condition. Following care, a medical attendant provided him with new non-military attire: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, said a drone blast had left him with a head injury. “My position was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or hear anything,” he explained. “I think I was lucky to remain alive. A relative has been killed. We face continuous explosions.” A construction worker employed in Lithuania, Filipchuk noted he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff placed him on a bed, removed a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. This may require a several months. Subsequently, to go back to my unit. Our forces must protect our nation,” he affirmed.

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

Over the past years, enemy forces has consistently targeted hospitals, health facilities, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been fatally attacked in almost 2,000 attacks. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material laid on top up to the surface. It can withstand impacts from large-caliber projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian steel and mining company, which funded the construction, plans to erect twenty facilities in all. A senior official of the nation's national security council and former military leader, Rustem Umerov, said they would be “critically important for preserving the survival of our armed forces and supporting troops on the battlefront.” The organization described the initiative as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained certain injured personnel had to wait hours or even days before they could be transported because of the danger of air assaults. “We had a pair of severely injured casualties who arrived at 3am. It was necessary to carry out a double amputation on a patient. His bleeding control device had been on for so long there was no alternative.” What is his method with traumatic surgeries? “My career in healthcare for 20 years. One must focus,” he said.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the other soldiers were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff paused for rest. The hospital’s orange feline, the mascot, padded up to the doorway to greet the incoming patients. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”