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Scrubby foliage hide the entrance. One sloping timber tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus shelves full of medical equipment, drugs and neat piles of extra garments. Within a break area with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an underground hospital look at a screen displaying Russian kamikaze and reconnaissance UAVs in the area.

Welcome to Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the safest way of delivering care to our injured soldiers. It also ensures medical personnel protected,” said the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point handles 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring surgical removal, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded soldiers in eastern Ukraine.

On one day recently, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a minor wound in his leg. “Conflict is terrible. My comrade beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the Russians dropped a second explosive on him.” He continued: “All structures in the settlement is destroyed. We see UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. The only way to reach their location was by walking. All supplies arrived by drone: rations and drinking water. Seven days after he was hurt, he walked five kilometers (roughly three miles), requiring three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his physical condition. After treatment, a nurse provided him with new civilian clothes: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a FPV drone caused a small hole in his leg.

Another patient, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. Suddenly it became black. I couldn’t feel anything or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been killed. There are ongoing detonations.” A builder working in Lithuania, Filipchuk said he had returned to his homeland and enlisted to serve shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the back. He groaned as medical staff laid him on a medical cot, removed a stained bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his sister. “A fragment of mortar hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To get better. This may require a few months. Subsequently, to go back to my military group. Someone must protect our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Since 2022, enemy forces has consistently targeted medical centers, clinics, obstetric units and emergency vehicles. Per international monitors, over two hundred health workers have been killed in nearly 2,000 assaults. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist direct hits from large-caliber artillery shells and even three 8kg TNT charges dropped by aerial means.

A major steel and mining company, which funded the construction, intends to erect 20 facilities in total. The head of the nation's national security council and former military leader, Rustem Umerov, declared they would be “critically essential for preserving the lives of our military and assisting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken since Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, said some injured personnel had to endure delays hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “Our facility received two critically ill casualties who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for so long there was no other option.” What is his method with traumatic operations? “I’ve been medicine for 20 years. You have to concentrate,” he said.

Orderlies transported the soldier up the passage and into an ambulance. The vehicle was parked beneath a shrub. He and the two other military members were taken to the urban center of a major city for additional medical care. 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 active 24 hours a day,” the surgeon stated. “The work is continuous.”