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Scrubby trees conceal the entryway. A sloping wooden tunnel leads down to a well-illuminated welcome zone. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus cabinets stocked of medical equipment, drugs and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, physicians keep an eye on a screen. It shows the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Medical personnel at an subterranean medical center observe a monitor displaying Russian kamikaze and reconnaissance UAVs in the area.

Welcome to Ukraine’s secret underground medical facility. This center opened in August and is the second such installation, located in the eastern part of the country not far from the frontline and the city of a key location in Donetsk oblast. “Our facility sits six meters under the earth. It’s the most secure method of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious stomach wounds. Others can walk. The vast majority are the victims of Russian 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 see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the subterranean installation for treating injured troops in eastern Ukraine.

During one afternoon last week, three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a minor wound in his limb. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the Russians released a second grenade on him.” He continued: “All structures in the village is destroyed. There are UAVs all around and casualties. Ours and the enemy's.”

Dvorskyi explained his squad endured 43 days in a forest area near the city, which enemy forces has been attempting to capture for many months. The only way to reach their position was on foot. Necessary provisions arrived by drone: food and water. Seven days following he was injured, he walked 5km (about 3 miles), taking several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic checked his vital signs. Following care, a medical attendant gave him new civilian clothes: a shirt and a pair of pale jeans.

Artem Dvorskiy, 28, said a FPV drone ripped a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “I was in a trench shelter. It suddenly became black. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. A relative has been lost. We face continuous explosions.” A builder employed in Lithuania, Filipchuk said he had returned to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors placed him on a medical cot, took off a stained bandage and cleaned his recent shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar hit me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. That will take a several months. After that, to return to my military group. Our forces must protect our nation,” he said.

Doctors care for Taras Mykolaichuk, who was injured in the back by a piece of artillery shell.

Since 2022, Russia has consistently attacked medical centers, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 health workers have been killed in nearly 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, earth and granular material placed above up to the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which financed the construction, plans to erect twenty units in total. A senior official of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “critically essential for saving the survival of our armed forces and supporting troops on the battlefront.” The company described the initiative as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

One of the facility's operating theatres.

Holovashchenko, explained certain injured personnel had to endure delays hours or even days before they could be transported due to the danger of air assaults. “Our facility received a pair of critically ill patients who arrived at the early hours. I had to carry out a removal of both limbs on a patient. The soldier's tourniquet had been applied for so long there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for two decades. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The transport was stationed beneath a bush. The patient and the two other military members were taken to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, the mascot, padded toward the doorway to greet the next arrivals. “Our facility operates open 24 hours a day,” Holovashchenko stated. “The work is continuous.”