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Sparse foliage hide the entryway. A sloping wooden passageway leads down to a brightly lit welcome zone. There is a surgery unit, equipped with beds, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Medical personnel at an underground hospital observe a screen showing Russian suicide and surveillance UAVs in the region.

This is Ukraine’s covert below-ground hospital. The facility began operations in August and is the second such installation, situated in the eastern part of the country not far from the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits six meters under the earth. This is the safest way of delivering care to our injured military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 casualties a each day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the victims of enemy FPV drones, which drop grenades with deadly accuracy. “Ninety per cent of our patients 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.

Major Oleksandr Holovashchenko at the subterranean installation for treating wounded troops in eastern Ukraine.

During one afternoon recently, a group of three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a small hole in his leg. “War is terrible. My comrade beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the Russians dropped a second grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs all around and bodies. Ours and the enemy's.”

Dvorskyi explained his squad endured 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their location was by walking. All supplies arrived by drone: rations and water. A week following he was injured, he walked 5km (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse provided him with new 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 leg.

A different casualty, 38-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or hear anything,” he said. “I think I was lucky to remain alive. My cousin has been killed. We face continuous detonations.” A builder employed in Lithuania, he said he had returned to Ukraine and enlisted to fight days before the Russian leader's large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a medical cot, took off a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his family member. “A fragment of artillery hit me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. This may require a few months. After that, to return to my unit. Someone has to protect our country,” he affirmed.

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

Since 2022, Russia has repeatedly targeted medical centers, clinics, maternity wards and ambulances. According to human rights groups, 261 health workers have been killed in almost two thousand assaults. The underground facility is built from multiple steel bunkers, with wooden supports, earth and sand placed above reaching the surface. It can withstand direct hits from 152mm projectiles and even three 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the construction, intends to erect 20 units in total. A senior official of the nation's national security council and ex- military leader, Rustem Umerov, said they would be “vitally essential for preserving the survival of our armed forces and supporting troops on the frontline.” The organization referred to the project as the “largest-scale and challenging” it had implemented since the enemy's military offensive.

An example of the facility's surgical rooms.

Holovashchenko, explained certain wounded personnel had to endure delays hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received two severely injured patients who arrived at 3am. I had to carry out a removal of both limbs on one of them. His tourniquet had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “I’ve been medicine for two decades. You have to focus,” he said.

Orderlies wheeled the soldier up the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. He and the other soldiers were transferred to the city of a major city for additional medical care. The underground medical team took a break. The facility's ginger cat, Vasilevs, walked up to the entrance to greet the incoming patients. “Our facility operates active around the clock,” Holovashchenko said. “It doesn’t stop.”