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Scrubby foliage hide the entryway. A descending timber passageway leads down to a well-illuminated reception area. There is a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. Plus cabinets stocked of medical equipment, medications and neat piles of extra garments. Within a break area with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Hospital personnel at an subterranean medical center look at a screen displaying Russian suicide and reconnaissance UAVs in the area.

This is Ukraine’s secret below-ground hospital. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the safest way of delivering care to our injured military personnel. It also ensures medical personnel protected,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Cases differ widely. Some have devastating leg injuries requiring surgical removal, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of Russian FPV aerial devices, which release explosives with lethal precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. It’s an era of drones and a new type of war,” the doctor said.

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

On one afternoon last week, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone explosion had torn a minor wound in his leg. “War is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the Russians dropped a another explosive on him.” He continued: “Everything in the village is demolished. We see drones everywhere and bodies. Our side's and the enemy's.”

Dvorskyi explained his squad spent 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to reach their position was on foot. All supplies came by quadcopter: rations and drinking water. A week following he was injured, he walked 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a set of pale jeans.

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

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “My position was in a trench shelter. It suddenly went dark. I lost sensation any feeling or any sound,” he explained. “I believe I was lucky to survive. My cousin has been killed. We face continuous detonations.” A construction worker working in a neighboring country, he noted he had come back to his homeland and volunteered to serve days before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors laid him on a bed, took off a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he used a cellphone to ring his sister. “A fragment of artillery struck me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to return to my military group. Someone must protect our country,” he affirmed.

Medical staff care for the wounded soldier, who was injured in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly targeted medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, earth and sand placed above up to ground level. It is designed to resist direct hits from 152mm artillery shells and even three 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to build twenty units in total. The head of the nation's security agency and ex- military leader, the official, said they would be “critically essential for saving the survival of our military and assisting troops on the battlefront.” The company referred to the initiative as the “largest-scale and demanding” it had implemented since Russia’s military offensive.

One of the centre’s surgical rooms.

The surgeon, explained some injured soldiers had to endure delays many hours or even multiple days before they could be transported because of the threat of aerial attacks. “Our facility received two critically ill casualties who came at the early hours. I had to perform a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” What is his method with traumatic surgeries? “My career in medicine for 20 years. You have to concentrate,” he said.

Orderlies transported Mykolaichuk up the passage and into an ambulance. The vehicle was parked under a shrub. He and the two other soldiers were transferred to the urban center of a major city for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded up to the doorway to greet the next arrivals. “We are active around the clock,” Holovashchenko stated. “It doesn’t stop.”