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Sparse trees conceal the entryway. A descending timber passageway descends to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, medications and organized stacks of extra garments. In a break area with a washing machine and kettle, physicians monitor a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital personnel at an subterranean hospital look at a screen showing enemy kamikaze and reconnaissance drones in the region.

This is Ukraine’s secret below-ground medical facility. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres below the ground. It’s the most secure method of delivering care to our wounded military personnel. And it keeps medical personnel protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the casualties of Russian first-person view (FPV) drones, which release explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see minimal bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded soldiers in eastern Ukraine.

During one day recently, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had torn a small hole in his leg. “Conflict is terrible. My comrade next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a second grenade on him.” He continued: “Everything in the settlement is destroyed. We see drones all around and casualties. Ours and theirs.”

Dvorskyi explained his squad spent 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies arrived by drone: rations and drinking water. A week after he was hurt, he walked five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medic checked his vital signs. After treatment, a nurse gave him new civilian clothes: a T-shirt and a pair of light-colored jeans.

The soldier, 28, said a first-person view aerial device ripped a minor injury in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “I was in a dugout. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I think I was fortunate to remain alive. My cousin has been lost. There are continuous explosions.” A builder employed in Lithuania, Filipchuk noted he had come back to Ukraine and enlisted to fight shortly before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as doctors laid him on a medical cot, took off a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his sister. “A fragment of artillery hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. That will take a few months. After that, to return to my unit. Someone must defend our country,” he affirmed.

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

Since 2022, enemy forces has consistently targeted hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, over two hundred medical personnel have been killed in almost two thousand attacks. The underground facility is constructed from four reinforced shelters, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to build 20 facilities in total. The head of the nation's security agency and former military leader, the official, said they would be “critically essential for saving the survival of our armed forces and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the facility's operating theatres.

The surgeon, explained certain wounded soldiers had to wait hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “We had a pair of severely injured casualties who came at 3am. It was necessary to perform 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 traumatic operations? “My career in medicine for two decades. One must focus,” he remarked.

Orderlies transported Mykolaichuk up the tunnel and into an ambulance. The transport was stationed under a bush. The patient and the other military members were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded toward the entrance to await the next arrivals. “Our facility operates open around the clock,” Holovashchenko stated. “The work is continuous.”