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Sparse trees conceal the entrance. A descending wooden passageway descends to a brightly lit welcome zone. There is a surgery unit, equipped with beds, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. In a break area with a washing machine and hot water heater, doctors monitor a screen. The screen reveals the movements of enemy spy drones as they zigzag in the sky above.

Medical staff at an underground medical center look at a screen displaying Russian kamikaze and surveillance UAVs in the region.

This is Ukraine’s secret underground medical facility. This center opened in August and is the second of its kind, located in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres below the earth. This is the safest way of delivering care to our wounded military personnel. It also ensures medical personnel safe,” said the clinic’s surgeon, Major the chief surgeon.

This medical station treats 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the victims of enemy FPV drones, which drop grenades with deadly precision. “90% of our cases are from FPVs. We see minimal bullet injuries. This is an age of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean installation for caring for injured soldiers in the eastern region.

During one day last week, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his limb. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the settlement is destroyed. There are UAVs everywhere and casualties. Ours and the enemy's.”

The soldier explained his unit spent 43 days in a wooded zone near the city, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies came by quadcopter: rations and water. Seven days after he was hurt, he walked five kilometers (about 3 miles), requiring several hours, to where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant gave him fresh civilian clothes: a shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device caused a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. Suddenly it became black. I lost sensation anything or any sound,” he said. “I think I was fortunate to remain alive. A relative has been lost. There are ongoing explosions.” A builder employed in a neighboring country, Filipchuk said he had returned to Ukraine and volunteered to serve shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a medical cot, removed a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of artillery hit me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my unit. Someone must defend our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was injured in the dorsal area by a fragment of artillery shell.

Since 2022, Russia has consistently targeted hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and granular material laid on top up to ground level. It can withstand impacts from 152mm artillery shells and even multiple 8kg explosive devices dropped by aerial means.

The Ukrainian industrial group, which financed the building, plans to erect twenty units in total. The head of the nation's national security council and former defence minister, Rustem Umerov, said they would be “critically important for preserving the survival of our armed forces and supporting troops on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had implemented after Russia’s invasion.

One of the centre’s operating theatres.

Holovashchenko, said some wounded personnel had to wait many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “We had two severely injured casualties who came at 3am. I had to carry out a removal of both limbs on a patient. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with traumatic operations? “My career in medicine for 20 years. You have to focus,” he said.

Orderlies wheeled Mykolaichuk through the tunnel and into an ambulance. The vehicle was parked beneath a bush. The patient and the other military members were taken to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked up to the entrance to greet the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”