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Scrubby foliage hide the entrance. A sloping wooden passageway descends to a brightly lit welcome zone. There is a surgery unit, equipped with beds, heart rate sensors and ventilators. Plus shelves stocked of medical equipment, medications and organized stacks of extra garments. In a break area with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

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

This is Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second of its kind, located in eastern Ukraine not far from the combat zone and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the safest way of providing help to our wounded soldiers. And it keeps medical personnel safe,” stated the clinic’s lead doctor, Major the chief surgeon.

This medical station treats 30-40 casualties a day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which release grenades with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

On one afternoon recently, a group of three military members 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. “War is terrible. My comrade next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a another grenade on him.” He added: “Everything in the settlement is demolished. There are UAVs all around and bodies. Ours and theirs.”

The soldier said his squad endured 43 days in a forest area close to the city, which Russia has been trying to seize since last year. Sole access to get to their location was by walking. All supplies arrived by quadcopter: food and water. Seven days following he was hurt, he walked five kilometers (roughly three miles), taking several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his physical condition. After treatment, a nurse provided him with new non-military attire: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, stated a first-person view aerial device ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. Suddenly it became black. I couldn’t feel any feeling or any sound,” he said. “I think I was fortunate to survive. A relative has been lost. There are ongoing explosions.” A builder working in Lithuania, Filipchuk noted he had returned to Ukraine and enlisted to fight shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as doctors laid him on a medical cot, took off a bloody bandage and cleaned his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to call his sister. “A piece of artillery hit me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. That will take a few months. After that, to go back to my unit. Our forces must protect our country,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently targeted medical centers, health facilities, obstetric units and ambulances. According to human rights groups, 261 health workers have been killed in nearly two thousand attacks. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist impacts from 152mm artillery shells and even three 8kg explosive devices released by aerial means.

A major steel and mining company, which funded the building, plans to erect twenty units in total. A senior official of the nation's security agency and former military leader, the official, said they would be “critically important for saving the lives of our armed forces and assisting defenders on the frontline.” The company described the project as the “largest-scale and demanding” it had undertaken after Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, said certain injured personnel had to endure delays hours or even days before they could be evacuated because of the threat of air assaults. “Our facility received two critically ill patients who came at 3am. I had to carry out a double amputation on a patient. The soldier's bleeding control device had been on for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “I’ve been healthcare for two decades. One must concentrate,” he said.

Orderlies wheeled Mykolaichuk through the passage and into an ambulance. The vehicle was stationed beneath a bush. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked toward the doorway to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko said. “The work is continuous.”