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Sparse trees conceal the entryway. A sloping wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, medications and neat piles of spare clothes. In 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 zigzag in the sky above.

Hospital personnel at an subterranean medical center look at a monitor displaying Russian kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s secret below-ground hospital. This center began operations in August and is the second such installation, situated in the eastern part of the country close to the combat zone and the urban area of a key location in Donetsk oblast. “We are 6 metres below the earth. This is the safest method of delivering care to our injured soldiers. It also ensures healthcare workers safe,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries necessitating surgical removal, or serious stomach wounds. Others can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter minimal bullet injuries. It’s an age of unmanned aircraft and a new type of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for injured troops in the eastern region.

On one day last week, a group of three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had ripped a small hole in his limb. “Conflict is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to get to their location was on foot. Necessary provisions came by quadcopter: rations and water. Seven days after he was hurt, he traveled 5km (about 3 miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. Following care, a nurse gave him new non-military attire: a T-shirt and a pair of pale denim trousers.

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

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he explained. “I think I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A builder working in Lithuania, Filipchuk noted he had returned to Ukraine and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors laid him on a bed, removed a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A piece of artillery hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. After that, to go back to my military group. Our forces must defend our nation,” he affirmed.

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

Over the past years, Russia has consistently targeted hospitals, clinics, maternity wards and ambulances. According to international monitors, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, soil and granular material laid on top reaching the surface. It is designed to resist impacts from 152mm artillery shells and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect twenty units in all. A senior official of the nation's national security council and ex- defence minister, Rustem Umerov, declared they would be “critically important for saving the lives of our military and supporting defenders on the frontline.” The company described the initiative as the “largest-scale and challenging” it had undertaken since the enemy's military offensive.

An example of the centre’s operating theatres.

The surgeon, said certain wounded personnel had to wait many hours or even days before they could be evacuated due to the threat of aerial attacks. “We had two severely injured casualties who arrived at 3am. It was necessary to perform a removal of both limbs on a patient. The soldier's bleeding control device had been on for such an extended period there was no other option.” How did he cope with traumatic operations? “My career in medicine for two decades. One must concentrate,” he remarked.

Medical assistants transported Mykolaichuk through the passage and into an ambulance. The transport was parked under a bush. The patient and the two other military members were taken to the city of a major city for further treatment. The subterranean hospital staff took a break. The facility's ginger cat, Vasilevs, padded up to the doorway to greet the incoming patients. “Our facility operates open around the clock,” Holovashchenko said. “The work is continuous.”