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Scrubby trees hide the entrance. One sloping wooden tunnel descends to a brightly lit reception area. There is a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus cabinets full of healthcare supplies, drugs and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, physicians monitor a display. It shows the movements of enemy spy drones as they weave in the sky above.

Hospital personnel at an underground hospital observe a screen showing Russian suicide and surveillance UAVs in the area.

Welcome to Ukraine’s secret underground hospital. The facility began operations in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres below the ground. It’s the most secure method of providing help to our wounded military personnel. It also ensures healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

This medical station handles thirty to forty patients a each day. Their conditions vary. Some have catastrophic limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with lethal precision. “90% of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of drones and a different kind of war,” the surgeon said.

Major the senior surgeon at the subterranean installation for caring for wounded soldiers in the eastern region.

During one day recently, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a small hole in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a another explosive on him.” He continued: “All structures in the settlement is destroyed. There are UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad endured over a month in a wooded zone near Pokrovsk, which Russia has been trying to seize since last year. Sole access to get to their location was on foot. All supplies came by quadcopter: rations and water. Seven days following he was injured, he walked 5km (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with new non-military attire: a shirt and a set of pale jeans.

Artem Dvorskiy, 28, stated a FPV aerial device caused a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “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 survive. My cousin has been lost. We face continuous detonations.” A builder working in a neighboring country, he said he had come back to Ukraine and enlisted to fight days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the back. He groaned as doctors placed him on a medical cot, removed a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my unit. Someone has to protect our country,” he said.

Doctors care for Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Since 2022, Russia has consistently attacked medical centers, health facilities, maternity wards and emergency vehicles. According to human rights groups, over two hundred health workers have been fatally attacked in nearly two thousand attacks. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material placed above up to the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which funded the building, intends to erect twenty units in total. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “critically important for preserving the lives of our military and assisting troops on the battlefront.” The organization referred to the project as the “largest-scale and demanding” it had implemented since Russia’s military offensive.

One of the facility's operating theatres.

Holovashchenko, said some injured soldiers had to endure delays hours or even days before they could be transported because of the threat of air assaults. “Our facility received two critically ill casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk up the passage and into an emergency vehicle. The transport was stationed under a shrub. He and the two other soldiers were transferred to the urban center of a major city for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, Vasilevs, walked up to the doorway to greet the next arrivals. “Our facility operates open around the clock,” the surgeon said. “It doesn’t stop.”