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Scrubby trees hide the entryway. A descending wooden tunnel leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets full of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, physicians monitor a display. The screen reveals the movements of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an underground medical center observe a screen showing Russian suicide and surveillance UAVs in the area.

Welcome to the nation's secret below-ground medical facility. The facility opened in the eighth month and is the second of its kind, located in eastern Ukraine close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits six meters below the ground. This is the safest way of delivering care to our wounded soldiers. And it keeps medical personnel protected,” stated the facility's lead doctor, Major the chief surgeon.

This medical station treats 30-40 casualties a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious stomach wounds. Some patients can move on their own. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which release grenades with deadly accuracy. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for treating wounded soldiers in eastern Ukraine.

On one afternoon last week, a group of three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a minor wound in his limb. “Conflict is horrific. My comrade next to me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces dropped a second explosive on him.” He added: “All structures in the settlement is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi said his squad spent over a month in a forest area near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their position was on foot. Necessary provisions arrived by drone: food and water. Seven days following he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his vital signs. Following care, a nurse provided him with new non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, stated a first-person view drone caused a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or hear anything,” he said. “I think I was lucky to survive. A relative has been killed. We face ongoing detonations.” A builder employed in Lithuania, Filipchuk noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He groaned as doctors placed him on a medical cot, removed a bloody dressing and treated his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his family member. “A piece of artillery hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to go back to my military group. Our forces must defend our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Since 2022, enemy forces has repeatedly attacked medical centers, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been killed in nearly 2,000 assaults. This subterranean hospital is built from multiple steel bunkers, with wooden supports, soil and sand laid on top up to the surface. It can withstand direct hits from large-caliber artillery shells and even three 8kg TNT charges dropped by drone.

A major steel and mining company, which funded the building, intends to erect twenty facilities in all. A senior official of Ukraine’s national security council and former defence minister, the official, said they would be “critically important for saving the survival of our military and assisting defenders on the frontline.” The company referred to the project as the “most ambitious and challenging” it had implemented since Russia’s military offensive.

An example of the facility's operating theatres.

The surgeon, said certain injured soldiers had to endure delays hours or even days before they could be evacuated due to the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. It was necessary to carry out a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “My career in medicine for two decades. One must concentrate,” he said.

Orderlies wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the two other soldiers were transferred to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's orange feline, the mascot, walked toward the doorway to await the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”