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Scrubby trees hide the entrance. One sloping wooden tunnel leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. And cabinets full of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, physicians monitor a screen. It shows the movements of enemy surveillance UAVs as they weave in the sky above.

Medical staff at an underground hospital look at a monitor showing enemy suicide and reconnaissance UAVs 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 eastern Ukraine close to the frontline and the city of a key location in Donetsk oblast. “We are six meters below the ground. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers safe,” stated the facility's surgeon, Maj the chief surgeon.

This medical station treats thirty to forty patients a day. Their conditions vary. Some have devastating leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy FPV drones, which release grenades with lethal precision. “90% of our cases are from first-person view drones. We see few bullet injuries. This is an age of drones and a different kind of war,” the doctor explained.

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

On one afternoon recently, a group of three military members walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an FPV blast had ripped a small hole in his leg. “Conflict is terrible. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the enemy forces dropped a another explosive on him.” He added: “All structures in the village is demolished. We see drones everywhere and bodies. Ours and the enemy's.”

The soldier explained his unit endured 43 days in a forest area close to the city, which Russia has been trying to seize for many months. The only way to reach their position was on foot. Necessary provisions came by drone: food and drinking water. A week after he was hurt, he walked 5km (roughly three miles), taking three hours, to where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a T-shirt and a set of pale jeans.

The soldier, 28, stated a FPV drone caused a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation anything or hear anything,” he said. “I think I was lucky to remain alive. A relative has been killed. There are continuous detonations.” A builder employed in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He groaned as doctors placed him on a bed, removed a stained dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of mortar hit me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to return to my unit. Our forces has to defend our nation,” he said.

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

Over the past years, Russia has consistently targeted hospitals, health facilities, obstetric units and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in nearly 2,000 assaults. The underground facility is built from multiple reinforced shelters, with wooden supports, soil and granular material laid on top up to the surface. It can withstand direct hits from large-caliber artillery shells and even multiple 8kg TNT charges released by drone.

The Ukrainian industrial group, which financed the building, plans to erect twenty units in total. A senior official of the nation's security agency and former defence minister, the official, declared they would be “critically essential for saving the lives of our military and assisting defenders on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken since Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained some injured personnel had to wait many hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at the early hours. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been applied for such an extended period there was no other option.” What is his method with severe operations? “I’ve been healthcare for two decades. One must focus,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked under a shrub. He and the other military members were taken to the city of Dnipro for further treatment. The subterranean 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,” Holovashchenko said. “It doesn’t stop.”