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Scrubby foliage hide the entrance. One descending wooden tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus shelves full of medical equipment, medications and neat piles of extra garments. Within a staff room with a washing machine and kettle, doctors keep an eye on a screen. It shows the movements of enemy spy drones as they zigzag in the sky above.

Hospital personnel at an subterranean hospital look at a screen displaying Russian kamikaze and surveillance drones in the area.

Welcome to Ukraine’s covert underground medical facility. This center began operations in the eighth month 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 6 metres under the earth. This is the safest method of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles 30-40 casualties a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Others can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which release grenades with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. This is an era of drones and a different kind of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the underground installation for treating wounded soldiers in eastern Ukraine.

During one day last week, a group of three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his leg. “Conflict is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces dropped a second grenade on him.” He continued: “All structures in the village is demolished. There are UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days in a forest area close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their position was by walking. All supplies arrived by quadcopter: food and water. Seven days after he was injured, he traveled five kilometers (roughly three miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a T-shirt and a set of pale denim trousers.

The soldier, 28, said a FPV aerial device caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he said. “I believe I was lucky to survive. A relative has been lost. We face ongoing detonations.” A construction worker working in a neighboring country, he noted he had come back to Ukraine and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a bed, took off a stained dressing and treated his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to call his family member. “A fragment of mortar hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. This may require a few months. Subsequently, to return to my unit. Our forces has to defend our nation,” he said.

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

Since 2022, Russia has repeatedly attacked medical centers, health facilities, maternity wards and ambulances. According to international monitors, over two hundred health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and sand placed above up to the surface. It can withstand impacts from large-caliber artillery shells and even three 8kg TNT charges dropped by drone.

The Ukrainian steel and mining company, which funded the building, intends to erect twenty facilities in all. A senior official of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “critically essential for preserving the lives of our military and supporting troops on the battlefront.” The company described the initiative as the “largest-scale and challenging” it had implemented after Russia’s invasion.

One of the facility's surgical rooms.

Holovashchenko, said certain wounded personnel had to endure delays hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had a pair of critically ill patients who came at 3am. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been on for such an extended period there was no other option.” How did he cope with traumatic operations? “My career in medicine for two decades. You have to focus,” he remarked.

Orderlies wheeled Mykolaichuk through the passage and into an ambulance. The transport was stationed under a shrub. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The facility's ginger cat, the mascot, walked up to the entrance to greet the incoming patients. “We are open 24 hours a day,” the surgeon stated. “The work is continuous.”