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Scrubby foliage conceal the entrance. One sloping wooden passageway leads down to a brightly lit reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. And cabinets full of healthcare supplies, medications and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, doctors monitor a screen. It shows the movements of enemy spy drones as they weave in the sky above.

Medical staff at an subterranean hospital observe a screen showing enemy kamikaze and surveillance UAVs in the area.

This is Ukraine’s secret below-ground medical facility. This center began operations in August and is the second of its kind, located in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres below the ground. It’s the most secure method of providing help to our wounded soldiers. It also ensures medical personnel safe,” said the facility's surgeon, Major the chief surgeon.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have devastating leg injuries requiring surgical removal, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of enemy FPV aerial devices, which drop grenades with deadly accuracy. “90% of our cases are from first-person view drones. We see few bullet injuries. This is an era of drones and a new type of war,” the surgeon explained.

Major the senior surgeon at the subterranean facility for caring for wounded troops in eastern Ukraine.

On one day recently, three soldiers limped into the hospital. The most lightly injured, 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 next to me, Vasyl, was killed,” he said. “He fell down. Then the Russians released a another explosive on him.” He continued: “All structures in the settlement is demolished. We see UAVs everywhere and casualties. Ours and the enemy's.”

The soldier explained his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture for many months. The only way to get to their location was by walking. Necessary provisions arrived by drone: food and drinking water. A week following he was injured, he walked 5km (about 3 miles), taking three hours, to where an military transport was able to evacuate him. Upon arrival, a medic checked his physical condition. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of light-colored jeans.

The soldier, 28, stated a first-person view drone ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “I was in a trench shelter. It suddenly became black. I lost sensation anything or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. We face continuous explosions.” A construction worker employed in a neighboring country, Filipchuk said he had returned to Ukraine and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the back. He groaned as doctors placed him on a medical cot, took off a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar hit me. The cause was a ricochet. My condition is stable,” 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. Someone must defend our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the dorsal area by a piece of mortar.

Since 2022, enemy forces has consistently targeted medical centers, clinics, maternity wards and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, soil and granular material laid on top up to ground level. It is designed to resist impacts from 152mm artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which funded the building, plans to erect twenty facilities in total. The head of Ukraine’s national security council and former defence minister, Rustem Umerov, said they would be “critically important for preserving the lives of our military and assisting defenders on the frontline.” The company referred to the project as the “most ambitious and challenging” it had undertaken since Russia’s military offensive.

One of the facility's operating theatres.

Holovashchenko, explained certain wounded personnel had to wait many hours or even days before they could be transported due to the threat of air assaults. “Our facility received two critically ill patients who came at 3am. I had to perform a double amputation on one of them. The soldier's tourniquet had been applied for so long there was no other option.” How did he cope with severe operations? “My career in medicine for 20 years. You have to concentrate,” he remarked.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. He and the other military members were transferred to the urban center of Dnipro 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 open around the clock,” Holovashchenko said. “The work is continuous.”