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Sparse foliage conceal the entryway. One sloping wooden tunnel descends to a well-illuminated welcome zone. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and ventilators. Plus shelves full of medical equipment, drugs and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a screen. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Medical personnel at an subterranean hospital observe a monitor displaying enemy suicide and reconnaissance drones in the area.

This is the nation's secret below-ground medical facility. This center began operations in August and is the second of its kind, situated in the eastern part of the country close to the frontline and the city of a key location in the Donetsk region. “Our facility sits six meters below the ground. This is the safest method of delivering care to our injured military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Cases differ widely. Some have devastating limb trauma requiring surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the casualties of Russian FPV aerial devices, which release grenades with deadly accuracy. “90% of our patients are from FPVs. We encounter few gunshot wounds. It’s an era of drones and a different kind of war,” the surgeon explained.

Major the senior surgeon at the subterranean installation for treating injured soldiers in eastern Ukraine.

On one afternoon recently, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an FPV explosion had torn a small hole in his limb. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Then the enemy forces released a second explosive on him.” He continued: “All structures in the village is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

The soldier explained his squad spent over a month in a wooded zone near Pokrovsk, which Russia has been trying to seize for many months. Sole access to get to their position was on foot. All supplies came by quadcopter: rations and water. A week following he was hurt, he traveled five kilometers (about 3 miles), requiring three hours, to where an military transport was able to evacuate him. Upon arrival, a medic checked his vital signs. After treatment, a medical attendant gave him new civilian clothes: a shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly became black. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. We face continuous explosions.” A builder employed in Lithuania, Filipchuk noted he had returned to his homeland and enlisted to fight days before the Russian leader's large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as doctors laid him on a bed, took off a stained dressing and treated his recent shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to ring his sister. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. This may require a few months. After that, to return to my unit. Someone has to protect our nation,” he said.

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

Over the past years, enemy forces has consistently targeted hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, soil and sand placed above reaching the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which financed the construction, intends to build twenty facilities in total. The head of Ukraine’s security agency and former defence minister, the official, declared they would be “vitally important for preserving the survival of our armed forces and supporting defenders on the battlefront.” The organization referred to the initiative as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the facility's operating theatres.

Holovashchenko, explained some injured personnel had to wait hours or even days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill casualties who came at the early hours. It was necessary to perform a double amputation on one of them. His tourniquet had been on for such an extended period there was no other option.” How did he cope with severe operations? “My career in medicine for 20 years. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked beneath a shrub. The patient and the other military members were transferred to the urban center of Dnipro for further treatment. The underground medical team took a break. The facility's ginger cat, Vasilevs, padded toward the entrance to await the incoming patients. “We are active 24 hours a day,” Holovashchenko stated. “The work is continuous.”