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Sparse foliage conceal the entrance. A descending timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, medications and neat piles of extra garments. In a staff room with a washing machine and kettle, physicians keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center look at a screen displaying Russian kamikaze and surveillance drones in the region.

Welcome to the nation's secret underground hospital. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country close to the combat zone and the urban area of a key location in the Donetsk region. “We are six meters under the ground. It’s the safest way of delivering care to our injured soldiers. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Others can move on their own. The vast majority are the victims of enemy FPV drones, which drop grenades with lethal accuracy. “Ninety per cent of our cases are from FPVs. We encounter few gunshot wounds. It’s an age of drones and a new type of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the subterranean installation for caring for injured troops in eastern Ukraine.

During one afternoon recently, a group of three soldiers walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians released a another grenade on him.” He added: “All structures in the village is demolished. We see UAVs everywhere and bodies. Our side's and the enemy's.”

Dvorskyi said his unit spent over a month in a wooded zone close to the city, which Russia has been trying to seize since last year. Sole access to get to their position was by walking. Necessary provisions arrived by quadcopter: rations and water. Seven days after he was injured, he traveled 5km (roughly three miles), requiring three hours, to a point where an military transport was able to pick him up. Upon arrival, a medic checked his physical condition. After treatment, a nurse gave him fresh non-military attire: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. It suddenly became black. I couldn’t feel anything or hear anything,” he explained. “I think I was lucky to remain alive. A relative has been lost. There are ongoing detonations.” A builder working in Lithuania, he noted he had returned to Ukraine and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as doctors placed him on a bed, took off a stained bandage and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to call his family member. “A piece of mortar struck me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to return to my unit. Our forces must protect our country,” he said.

Doctors treat the wounded soldier, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, maternity wards and ambulances. Per international monitors, over two hundred medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is constructed from four steel bunkers, with wooden supports, earth and granular material laid on top up to the surface. It is designed to resist direct hits from large-caliber artillery shells and even three 8kg TNT charges released by aerial means.

The Ukrainian industrial group, which financed the building, plans to erect twenty units in total. The head of Ukraine’s national security council and former defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our military and assisting defenders on the battlefront.” The company described the project as the “most ambitious and challenging” it had implemented since Russia’s invasion.

An example of the facility's surgical rooms.

Holovashchenko, explained some injured soldiers had to wait hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received two severely injured casualties who came at the early hours. It was necessary to perform a removal of both limbs on a patient. The soldier's tourniquet had been on for such an extended period there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was parked beneath a bush. He and the two other military members were transferred to the urban center of a major city for further treatment. The underground medical team paused for rest. The hospital’s orange feline, the mascot, walked toward the entrance to greet the next arrivals. “We are open around the clock,” the surgeon said. “It doesn’t stop.”