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Scrubby trees conceal the entrance. A descending timber passageway descends to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets stocked of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, doctors keep an eye on a display. The screen reveals the movements of enemy spy drones as they zigzag in the air above.

Medical staff at an underground medical center look at a screen displaying Russian kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second such installation, located in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres below the earth. It’s the safest method of delivering care to our injured soldiers. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 patients a day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring surgical removal, or serious stomach wounds. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which drop explosives with lethal accuracy. “90% of our patients are from first-person view drones. We see few bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj the senior surgeon at the subterranean installation for treating wounded soldiers in the eastern region.

During one day last week, three military members limped into the hospital. The most lightly injured, 28-year-old one soldier, said an first-person view drone blast had torn a minor wound in his limb. “Conflict is terrible. My comrade beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the Russians dropped a second explosive on him.” He added: “Everything in the settlement is demolished. We see drones all around and bodies. Our side's and theirs.”

The soldier explained his unit spent 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to reach their location was on foot. All supplies arrived by quadcopter: food and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a set of pale jeans.

Artem Dvorskiy, 28, said a FPV aerial device ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a dugout. It suddenly became black. I couldn’t feel any feeling or any sound,” he explained. “I think I was lucky to survive. A relative has been lost. There are continuous detonations.” A builder working in Lithuania, Filipchuk noted he had come back to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a bed, took off a bloody dressing and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a cellphone to ring his sister. “A piece of artillery struck me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to return to my unit. Someone must defend our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the back by a fragment of artillery shell.

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, obstetric units and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and sand laid on top up to ground level. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to build 20 units in total. The head of the nation's national security council and former defence minister, the official, said they would be “vitally essential for saving the lives of our armed forces and assisting troops on the battlefront.” The company described the initiative as the “largest-scale and demanding” it had undertaken after Russia’s invasion.

An example of the facility's surgical rooms.

The surgeon, explained some injured soldiers had to wait hours or even days before they could be evacuated because of the threat of air assaults. “We had two severely injured patients who came at the early hours. I had to perform a double amputation on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” How did he cope with severe operations? “My career in medicine for two decades. You have to focus,” he said.

Medical assistants transported Mykolaichuk up the tunnel and into an ambulance. The transport was stationed under a shrub. The patient and the other military members were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked toward the entrance to greet the incoming patients. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”