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Sparse trees hide the entrance. One sloping wooden tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus shelves full of medical equipment, drugs and organized stacks of extra garments. Within a break area with a washing machine and kettle, physicians monitor a display. The screen reveals the movements of Russian surveillance UAVs as they zigzag in the sky above.

Hospital personnel at an underground medical center observe a monitor showing Russian kamikaze and surveillance UAVs in the region.

Welcome to the nation's covert below-ground hospital. The facility opened in the eighth month and is the second such installation, situated in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure method of delivering care to our wounded military personnel. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Major the chief surgeon.

The stabilisation point treats 30-40 casualties a day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or serious stomach wounds. Others can move on their own. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with lethal precision. “90% of our patients are from first-person view drones. We see few gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the doctor explained.

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

During one afternoon last week, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a small hole in his limb. “War is terrible. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the enemy forces released a second explosive on him.” He added: “Everything in the settlement is demolished. There are UAVs all around and casualties. Our side's and the enemy's.”

The soldier said his unit endured 43 days in a forest area near Pokrovsk, which enemy forces has been attempting to capture for many months. The only way to reach their position was by walking. Necessary provisions arrived by drone: rations and drinking water. A week after he was injured, he traveled five kilometers (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic checked his vital signs. Following care, a medical attendant gave him new civilian clothes: a shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view drone caused a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I lost sensation anything or any sound,” he explained. “I believe I was lucky to survive. My cousin has been lost. We face ongoing detonations.” A construction worker employed in a neighboring country, he said he had returned to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a medical cot, removed a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of artillery struck me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my unit. Our forces must defend our nation,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Over the past years, enemy forces has consistently attacked medical centers, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred health workers have been fatally attacked in nearly 2,000 assaults. The underground facility is built from four steel bunkers, with timber beams, earth and granular material placed above up to the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the construction, plans to erect twenty units in all. The head of the nation's security agency and ex- military leader, the official, declared they would be “critically important for preserving the survival of our armed forces and supporting troops on the frontline.” The company described the initiative as the “most ambitious and demanding” it had implemented since Russia’s invasion.

One of the facility's operating theatres.

The surgeon, explained certain 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 critically ill casualties who came at 3am. I had to perform a double amputation on a patient. The soldier's bleeding control device had been on for so long there was no alternative.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants transported Mykolaichuk through the passage and into an emergency vehicle. The transport was parked under a bush. He and the two other military members were transferred to the city of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s orange feline, the mascot, walked up to the doorway to await the next arrivals. “Our facility operates open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”