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Sparse trees conceal the entryway. One sloping wooden tunnel leads down to a brightly lit reception area. There is a operating ward, equipped with gurneys, cardiac monitors and breathing machines. Plus shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a washing machine and kettle, physicians monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital personnel at an underground hospital look at a screen showing enemy kamikaze and surveillance UAVs in the area.

Welcome to the nation'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 frontline and the city of a key location in the Donetsk region. “Our facility sits six meters below the ground. This is the most secure way of delivering care to our wounded military personnel. It also ensures healthcare workers protected,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station handles 30-40 patients a day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) aerial devices, which release grenades with deadly precision. “90% of our patients are from first-person view drones. We see few gunshot wounds. This is an era of drones and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for caring for injured soldiers in eastern Ukraine.

On one day last week, a group of three military members limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his limb. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the settlement is destroyed. We see drones all around and casualties. Our side's and theirs.”

The soldier explained his squad spent over a month in a forest area close to the city, which enemy forces has been attempting to capture since last year. Sole access to get to their position was by walking. All supplies came by quadcopter: food and drinking water. Seven days after he was hurt, he walked five kilometers (about 3 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. After treatment, a nurse gave him new civilian clothes: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device caused a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been killed. There are ongoing explosions.” A builder employed in a neighboring country, he noted he had come back to his homeland and volunteered to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a medical cot, took off a stained bandage and treated his recent injury from fragments. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A piece of mortar struck me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to return to my unit. Someone has to protect our country,” he said.

Doctors treat the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Over the past years, Russia has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. Per international monitors, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from multiple reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It can withstand impacts from 152mm projectiles and even three 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which financed the construction, plans to erect 20 facilities in all. A senior official of Ukraine’s national security council and ex- military leader, the official, declared they would be “vitally important for saving the lives of our armed forces and supporting troops on the battlefront.” The organization described the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, explained certain wounded soldiers had to endure delays many hours or even days before they could be transported due to the danger of aerial attacks. “We had two severely injured casualties who arrived at the early hours. It was necessary to carry out a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. You have to concentrate,” he said.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The transport was stationed beneath a bush. The patient and the two other military members were transferred to the urban center of a major city for further treatment. The underground hospital staff took a break. The facility's orange feline, Vasilevs, walked up to the entrance to await the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”