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Sparse trees conceal the entrance. A sloping timber passageway leads down to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a laundry appliance and kettle, physicians monitor a screen. It shows the movements of enemy spy drones as they weave in the air above.

Medical staff at an underground medical center look at a monitor showing enemy suicide and reconnaissance UAVs in the area.

This is Ukraine’s covert below-ground medical facility. This center began operations in August and is the second of its kind, 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 below the ground. It’s the most secure method of delivering care to our wounded soldiers. And it keeps healthcare workers safe,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of Russian FPV drones, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see few bullet injuries. This is an age of drones and a different kind of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the underground facility for treating injured troops in eastern Ukraine.

During one day last week, a group of three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is horrific. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He fell down. Subsequently the Russians dropped a another grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs everywhere and bodies. Our side's and the enemy's.”

Dvorskyi explained his unit endured over a month in a wooded zone close to the city, which Russia has been trying to seize since last year. Sole access to get to their location was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week after he was hurt, he walked 5km (about 3 miles), taking several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his vital signs. After treatment, a medical attendant gave him fresh civilian clothes: a T-shirt and a set of pale denim trousers.

The soldier, 28, stated a first-person view aerial device caused a minor injury in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a dugout. It suddenly became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been lost. We face continuous detonations.” A builder working in Lithuania, he noted he had come back to Ukraine and volunteered to fight shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a bed, took off a stained bandage and cleaned his recent shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his sister. “A piece of mortar struck me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. That will take a several months. After that, to go back to my military group. Someone must protect our country,” he said.

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

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred health workers have been killed in almost 2,000 assaults. The underground facility is built from multiple steel bunkers, with wooden supports, soil and sand placed above up to the surface. It can withstand impacts from 152mm projectiles and even three eight-kilogram explosive devices dropped by drone.

The Ukrainian steel and mining company, which financed the building, intends to build twenty units in total. A senior official of the nation's security agency and ex- military leader, the official, declared they would be “vitally essential for saving the survival of our military and assisting troops on the battlefront.” The company referred to the project as the “largest-scale and challenging” it had undertaken since the enemy's invasion.

One of the facility's operating theatres.

Holovashchenko, said certain wounded personnel had to endure delays hours or even multiple days before they could be evacuated because of the threat of air assaults. “Our facility received two severely injured casualties who arrived at 3am. It was necessary to perform a double amputation on one of them. The soldier's tourniquet had been applied for such an extended period there was no alternative.” How did he cope with traumatic operations? “My career in medicine for two decades. One must focus,” he said.

Orderlies transported the soldier through the passage and into an ambulance. The transport was stationed beneath a shrub. The patient and the two other military members were transferred to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, Vasilevs, padded up to the entrance to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”