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Scrubby foliage hide the entryway. A descending timber tunnel descends to a brightly lit reception area. Inside lies a operating ward, equipped with beds, cardiac monitors and ventilators. And cabinets full of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital personnel at an underground medical center observe a monitor displaying enemy suicide and reconnaissance UAVs in the region.

This is the nation's secret underground hospital. This center began operations in the eighth month and is the second such installation, situated in the eastern part of the country not far from the frontline and the city of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the most secure way of delivering care to our injured soldiers. And it keeps medical personnel protected,” stated the clinic’s surgeon, Maj the chief surgeon.

This medical station handles thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from devastating leg injuries necessitating surgical removal, or serious abdominal injuries. 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 first-person view drones. We see minimal gunshot wounds. This is an era of drones and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded troops in the eastern region.

During one day recently, a group of three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his limb. “War is terrible. My comrade beside me, Vasyl, was killed,” he said. “He fell down. Subsequently the enemy forces released a second grenade on him.” He added: “All structures in the village is demolished. We see UAVs everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his unit endured 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to reach their position was on foot. Necessary provisions came by drone: rations and drinking water. Seven days after he was hurt, he traveled five kilometers (roughly three miles), requiring several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone caused a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was lucky to survive. A relative has been killed. There are ongoing explosions.” A builder employed in Lithuania, he said he had come back to his homeland and enlisted to fight shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors placed him on a medical cot, removed a bloody bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to go back to my unit. Someone must protect our nation,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is built from four reinforced shelters, with wooden supports, earth and sand placed above reaching the surface. It can withstand direct hits from 152mm artillery shells and even multiple eight-kilogram TNT charges released by drone.

A major steel and mining company, which financed the construction, plans to build 20 facilities in all. A senior official of Ukraine’s national security council and ex- military leader, Rustem Umerov, declared they would be “critically important for saving the survival of our military and supporting defenders on the frontline.” The company described the project as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, said some injured soldiers had to endure delays many hours or even days before they could be transported because of the threat of air assaults. “Our facility received two severely injured patients who arrived at the early hours. I had to carry out a double amputation on a patient. His bleeding control device had been applied for so long there was no other option.” What is his method with traumatic surgeries? “My career in medicine for 20 years. One must focus,” he said.

Medical assistants transported Mykolaichuk through the passage and into an ambulance. The transport was stationed beneath a bush. He and the two other soldiers were taken to the city of Dnipro for additional medical care. The subterranean medical team took a break. The hospital’s ginger cat, the mascot, padded up to the doorway to greet the incoming patients. “Our facility operates active around the clock,” Holovashchenko stated. “The work is continuous.”