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Scrubby trees hide the entryway. A descending timber passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, medications and organized stacks of extra garments. In a break area with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground medical center observe a monitor showing Russian suicide and surveillance drones in the region.

Welcome to the nation's secret underground medical facility. This center began operations in the eighth month and is the second of its kind, located in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “We are 6 metres below the ground. This is the most secure method of delivering care to our wounded soldiers. And it keeps medical personnel safe,” stated the facility's lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our patients are from FPVs. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a new type of war,” the doctor explained.

Major the senior surgeon at the subterranean facility for caring for wounded troops in eastern Ukraine.

On one afternoon recently, a group of three military members limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “Conflict is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians released a second grenade on him.” He added: “All structures in the village is demolished. We see drones everywhere and bodies. Ours and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize for many months. Sole access to get to their position was by walking. Necessary provisions arrived by drone: rations and drinking water. Seven days following he was injured, he walked five kilometers (roughly three miles), taking three hours, to where an military transport was able to pick him up. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of pale jeans.

The soldier, twenty-eight, said a first-person view aerial device ripped a small hole in his lower limb.

A different casualty, 38-year-old a serviceman, said a UAV explosion had left him with concussion. “I was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or any sound,” he explained. “I believe I was fortunate to survive. A relative has been lost. We face continuous detonations.” A builder employed in Lithuania, he said he had returned 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 hit in the back. He groaned as doctors laid him on a medical cot, took off a stained dressing and treated his recent injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to call his sister. “A fragment of mortar struck me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. This may require a several months. After that, to return to my unit. Someone has to defend our country,” he said.

Doctors care for Taras Mykolaichuk, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, earth and sand laid on top up to ground level. It is designed to resist direct hits from large-caliber projectiles and even multiple 8kg TNT charges released by drone.

A major steel and mining company, which funded the building, plans to erect twenty units in total. The head of Ukraine’s national security council and former defence minister, the official, said they would be “critically 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 challenging” it had undertaken after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, said some wounded personnel had to endure delays hours or even multiple days before they could be evacuated because of the threat of air assaults. “We had two critically ill casualties who came at the early hours. It was necessary to perform a double amputation on a patient. The soldier's bleeding control device had been on for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. You have to focus,” he said.

Medical assistants wheeled the soldier up the tunnel and into an ambulance. The vehicle was parked under a shrub. The patient and the two other military members were transferred to the city of a major city for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, the mascot, walked toward the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”