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Scrubby foliage hide the entryway. One sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus shelves 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 air above.

Hospital staff at an subterranean medical center observe a monitor showing enemy kamikaze and reconnaissance UAVs in the area.

Welcome to the nation's secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, situated in the eastern part of the country not far from the frontline and the city of Pokrovsk in the Donetsk region. “We are six meters below the earth. It’s the most secure way of delivering care to our injured soldiers. And it keeps medical personnel protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 casualties a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop explosives with deadly precision. “90% of our cases are from first-person view drones. We see few bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the surgeon said.

Major the senior surgeon at the underground facility for treating wounded soldiers in eastern Ukraine.

During one day recently, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his leg. “Conflict is horrific. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He added: “Everything in the village is demolished. We see UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad spent over a month in a forest area close to the city, which Russia has been attempting to capture since last year. The only way to reach their position was by walking. Necessary provisions arrived by drone: rations and water. A week after he was injured, he traveled 5km (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with new civilian clothes: a T-shirt and a set of light-colored jeans.

The soldier, twenty-eight, stated a first-person view aerial device caused a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “My position was in a trench shelter. It suddenly went dark. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been lost. We face continuous explosions.” A builder working in a neighboring country, Filipchuk said he had returned to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, took off a bloody bandage and cleaned his recent shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to ring his sister. “A fragment of mortar struck me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. This may require a few months. After that, to go back to my unit. Someone must defend our country,” he said.

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

Since 2022, Russia has repeatedly attacked hospitals, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with timber beams, soil and granular material laid on top up to the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which financed the construction, plans to build twenty units in total. A senior official of Ukraine’s national security council and former military leader, the official, declared they would be “critically important for preserving the lives of our military and supporting defenders on the frontline.” The organization described the project as the “most ambitious and demanding” it had undertaken after the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, explained certain injured personnel had to endure delays many hours or even multiple days before they could be transported because of the danger of air assaults. “We had a pair of severely injured patients who arrived at the early hours. It was necessary to perform a removal of both limbs on a patient. His tourniquet had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “I’ve been healthcare for 20 years. You have to focus,” he remarked.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the other soldiers were taken to the city of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, the mascot, walked toward the doorway to greet the next arrivals. “Our facility operates open around the clock,” Holovashchenko stated. “The work is continuous.”