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Sparse foliage hide the entrance. One descending timber passageway leads down to a brightly lit reception area. There is a operating ward, equipped with beds, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, medications and organized stacks of spare clothes. Within a break area with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

Hospital staff at an underground hospital look at a monitor displaying enemy suicide and reconnaissance drones in the region.

This is Ukraine’s secret below-ground hospital. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres under the ground. It’s the most secure way of delivering care to our injured military personnel. And it keeps healthcare workers protected,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which release grenades with lethal precision. “90% of our cases are from first-person view drones. We encounter few gunshot wounds. This is an age of unmanned aircraft and a new type of war,” the doctor said.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded soldiers in the eastern region.

During one day last week, three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone explosion had torn a minor wound in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a another grenade on him.” He continued: “Everything in the settlement is destroyed. There are drones all around and casualties. Our side's and the enemy's.”

The soldier explained his unit endured 43 days in a wooded zone near the city, which Russia has been attempting to capture for many months. The only way to get to their location was by walking. All supplies arrived by quadcopter: rations and drinking water. Seven days following he was injured, he traveled 5km (about 3 miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his physical condition. Following care, a nurse provided him with new non-military attire: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, said a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or any sound,” he explained. “I think I was lucky to remain alive. A relative has been lost. We face ongoing detonations.” A builder working 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.

A third soldier, a serviceman, had been hit in the back. He groaned as doctors placed him on a medical cot, removed a bloody dressing and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a cellphone to ring his sister. “A fragment of artillery hit me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to go back to my unit. Our forces has to protect our nation,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of mortar.

Since 2022, enemy forces has repeatedly attacked hospitals, health facilities, maternity wards and emergency vehicles. Per human rights groups, over two hundred health workers have been killed in almost two thousand attacks. The underground facility is constructed from four reinforced shelters, with timber beams, earth and sand placed above up to the surface. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian steel and mining company, which financed the construction, plans to erect twenty facilities in all. A senior official of the nation's security agency and former military leader, Rustem Umerov, said they would be “critically essential for saving the survival of our armed forces and assisting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, explained some wounded soldiers had to wait many hours or even multiple days before they could be evacuated because of the danger of aerial attacks. “We had a pair of critically ill casualties who came at 3am. It was necessary to perform a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for two decades. One must concentrate,” he said.

Orderlies transported the soldier through the tunnel and into an ambulance. The vehicle was stationed beneath a shrub. He and the other military members were transferred to the urban center of a major city for additional medical care. The underground medical team took a break. The hospital’s ginger cat, Vasilevs, padded up to the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”