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Scrubby foliage hide the entryway. A sloping timber passageway descends to a brightly lit welcome zone. There is a surgery unit, equipped with gurneys, cardiac monitors and breathing machines. And shelves stocked of medical equipment, medications and organized stacks of extra garments. Within a staff room with a washing machine and hot water heater, doctors monitor a display. It shows the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an underground medical center observe a screen displaying enemy suicide and reconnaissance drones in the area.

This is the nation's covert underground hospital. The facility opened in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the most secure way of delivering care to our wounded soldiers. It also ensures medical personnel safe,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty patients a day. Their conditions vary. Some have devastating leg injuries necessitating surgical removal, or serious stomach wounds. Others can walk. Almost all are the victims of enemy first-person view (FPV) aerial devices, which release grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

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

On one afternoon recently, three military members limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his limb. “War is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the village is demolished. There are drones all around and casualties. Ours and theirs.”

The soldier explained his squad spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to reach their position was on foot. All supplies came by drone: rations and drinking water. A week after he was hurt, he traveled 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant provided him with new civilian clothes: a shirt and a pair of light-colored jeans.

The soldier, twenty-eight, stated a FPV drone ripped a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I couldn’t feel anything or hear anything,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. There are continuous detonations.” A construction worker working in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a bloody dressing and treated his recent injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my military group. Someone must protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a fragment of mortar.

Since 2022, Russia has consistently targeted medical centers, clinics, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and granular material laid on top reaching ground level. It is designed to resist impacts from large-caliber projectiles and even multiple eight-kilogram TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect 20 facilities in total. The head of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for saving the survival of our military and supporting troops on the battlefront.” The company described the project as the “most ambitious and demanding” it had implemented since Russia’s military offensive.

One of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to endure delays hours or even days before they could be evacuated due to the danger of aerial attacks. “We had two critically ill patients who arrived at 3am. I had to carry out a double amputation on a patient. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been medicine for two decades. You have to concentrate,” he said.

Orderlies wheeled the soldier through the passage and into an ambulance. The vehicle was stationed under a shrub. The patient and the other military members were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked up to the entrance to await the incoming patients. “We are active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”