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Sparse foliage hide the entrance. One descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. And shelves full of medical equipment, medications and organized stacks of spare clothes. In a break area with a washing machine and kettle, physicians keep an eye on a screen. It shows the movements of enemy surveillance UAVs as they weave in the air above.

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

This is the nation's secret underground medical facility. This center opened in August and is the second of its kind, located in eastern Ukraine close to the combat zone and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres below the ground. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers safe,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or severe stomach wounds. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop explosives with lethal precision. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of war,” the surgeon said.

Maj the senior surgeon at the subterranean installation for treating injured troops in the eastern region.

On one afternoon recently, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a small hole in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a another explosive on him.” He continued: “Everything in the settlement is demolished. We see drones all around and bodies. Our side's and the enemy's.”

The soldier said his squad spent over a month in a wooded zone near the city, which Russia has been trying to seize since last year. Sole access to reach their position was by walking. All supplies came by quadcopter: food and water. A week following he was injured, he walked five kilometers (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse provided him with fresh civilian clothes: a shirt and a set of pale denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “My position was in a trench shelter. It suddenly became black. I lost sensation any feeling or any sound,” he said. “I believe I was lucky to remain alive. My cousin has been lost. We face ongoing detonations.” A builder employed in a neighboring country, he said he had returned to his homeland and volunteered to serve days 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 doctors laid him on a medical cot, took off a bloody bandage and treated his recent injury from fragments. Covered in a foil blanket, he used a cellphone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. After that, to go back to my military group. Our forces must protect our country,” he said.

Medical staff treat the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted medical centers, clinics, maternity wards and ambulances. Per human rights groups, 261 health workers have been killed in nearly two thousand assaults. This subterranean hospital is built from multiple steel bunkers, with timber beams, soil and sand laid on top reaching ground level. It can withstand direct hits from 152mm projectiles and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which financed the construction, intends to build 20 facilities in total. The head of the nation's national security council and former defence minister, the official, declared they would be “critically essential for saving the lives of our armed forces and supporting defenders on the frontline.” The company referred to the project as the “most ambitious and demanding” it had undertaken after the enemy's military offensive.

An example of the centre’s operating theatres.

The surgeon, said certain wounded soldiers had to wait many hours or even days before they could be evacuated due to the threat of air assaults. “Our facility received two critically ill casualties who came at the early hours. It was necessary to perform a removal of both limbs on one of them. His tourniquet had been on for such an extended period there was no other option.” How did he cope with severe operations? “My career in healthcare for two decades. One must concentrate,” he remarked.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The transport was parked beneath a bush. He and the other military members were taken to the city of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, the mascot, walked toward the entrance to await the incoming patients. “We are active around the clock,” Holovashchenko stated. “It doesn’t stop.”