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Sparse trees hide the entryway. A sloping wooden passageway descends to a brightly lit reception area. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the movements of Russian surveillance UAVs as they weave in the sky above.

Medical personnel at an underground hospital look at a screen displaying Russian suicide and surveillance UAVs in the area.

Welcome to Ukraine’s covert below-ground hospital. This center opened in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the city of a key location in the Donetsk region. “We are six meters under the earth. This is the most secure way of providing help to our wounded soldiers. It also ensures healthcare workers safe,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries requiring amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of Russian FPV aerial devices, which drop grenades with lethal precision. “90% of our cases are from first-person view drones. We see minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for injured soldiers in the eastern region.

On one day recently, three soldiers limped into the hospital. The most lightly injured, 28-year-old one soldier, reported an first-person view drone explosion had ripped a minor wound in his limb. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is destroyed. We see UAVs all around and bodies. Ours and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their location was on foot. Necessary provisions came by quadcopter: rations and drinking water. Seven days after he was injured, he walked five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff assessed his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a T-shirt and a pair of pale denim trousers.

The soldier, 28, stated a FPV aerial device ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a trench shelter. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I think I was fortunate to remain alive. A relative has been killed. There are continuous detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a bed, took off a bloody bandage and cleaned his two-day-old shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to ring his family member. “A fragment of mortar struck me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. After that, to return to my unit. Our forces has to protect our nation,” he said.

Doctors treat Taras Mykolaichuk, who was hit in the back by a piece of mortar.

Since 2022, Russia has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 medical personnel have been killed in nearly 2,000 attacks. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and granular material placed above up to the surface. It can withstand impacts from 152mm artillery shells and even multiple eight-kilogram explosive devices released by aerial means.

A major steel and mining company, which financed the construction, plans to erect twenty facilities in all. The head of Ukraine’s security agency and ex- military leader, the official, said they would be “vitally essential for preserving the survival of our military and assisting defenders on the battlefront.” The organization described the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the centre’s operating theatres.

Holovashchenko, explained some injured personnel had to wait hours or even days before they could be transported because of the danger of air assaults. “Our facility received two critically ill patients who arrived at 3am. I had to carry out a double amputation on one of them. The soldier's tourniquet had been applied for such an extended period there was no other option.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he said.

Orderlies transported the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. He and the other soldiers were transferred to the urban center of a major city for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, the mascot, walked up to the entrance to greet the next arrivals. “Our facility operates active around the clock,” the surgeon said. “It doesn’t stop.”