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Scrubby trees conceal the entrance. A descending wooden tunnel descends to a brightly lit welcome zone. There is a surgery unit, equipped with beds, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. Within a break area with a washing machine and hot water heater, physicians monitor a screen. It shows the flight patterns of enemy spy drones as they zigzag in the sky above.

Medical staff at an underground medical center look at a screen displaying Russian kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s secret below-ground hospital. The facility opened in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the urban area of a key location in Donetsk oblast. “We are 6 metres under the ground. This is the safest method of delivering care to our wounded military personnel. It also ensures healthcare workers protected,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Cases differ widely. Some have catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) aerial devices, which drop explosives with lethal accuracy. “90% of our patients are from FPVs. We see few bullet injuries. It’s an era of drones and a new type of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for treating wounded soldiers in eastern Ukraine.

During one day recently, a group of three military members limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV blast had ripped a minor wound in his leg. “War is horrific. The guy next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second explosive on him.” He continued: “All structures in the village is destroyed. There are drones everywhere and bodies. Ours and the enemy's.”

The soldier explained his unit spent over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to reach their position was on foot. All supplies came by quadcopter: food and water. Seven days following he was hurt, he walked 5km (roughly three miles), taking several hours, to a point where an military transport was able to pick him up. At the clinic, a medic assessed his physical condition. Following care, a medical attendant provided him with new non-military attire: a shirt and a set of pale jeans.

Artem Dvorskiy, 28, said a FPV aerial device ripped a minor injury 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 dugout. It suddenly went dark. I lost sensation any feeling or any sound,” he said. “I think I was fortunate to remain alive. My cousin has been killed. We face ongoing explosions.” A builder working in Lithuania, he said he had returned to Ukraine and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff laid him on a bed, took off a stained bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to ring his family member. “A piece of artillery hit me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. That will take a few months. Subsequently, to go back to my unit. Someone must protect our nation,” he affirmed.

Doctors care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, Russia has consistently attacked medical centers, clinics, maternity wards and emergency vehicles. Per human rights groups, over two hundred health workers have been killed in almost two thousand assaults. This subterranean hospital is built from four steel bunkers, with wooden supports, soil and granular material placed above up to the surface. It can withstand direct hits from large-caliber projectiles and even multiple 8kg explosive devices released by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect 20 units in total. The head of the nation's national security council and former military leader, the official, declared they would be “critically essential for saving the survival of our military and supporting troops on the frontline.” The organization referred to the project as the “most ambitious and challenging” it had undertaken since Russia’s military offensive.

An example of the centre’s operating theatres.

The surgeon, said certain wounded soldiers had to wait many hours or even days before they could be transported due to the threat of aerial attacks. “We had two critically ill casualties who arrived at the early hours. I had to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been on for so long there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to focus,” he remarked.

Orderlies wheeled the soldier up the passage and into an emergency vehicle. The vehicle was parked under a bush. The patient and the other military members were taken to the urban center of Dnipro for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, the mascot, padded toward the doorway to await the incoming patients. “We are active 24 hours a day,” Holovashchenko said. “The work is continuous.”