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Scrubby foliage conceal the entrance. A sloping timber tunnel leads down to a well-illuminated reception area. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. And cabinets full of healthcare supplies, medications and organized stacks of extra garments. In a staff room with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the movements of Russian surveillance UAVs as they zigzag in the air above.

Hospital staff at an subterranean medical center observe a screen displaying Russian suicide and reconnaissance UAVs in the region.

This is the nation's covert underground medical facility. This center began operations in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of a key location in the Donetsk region. “Our facility sits six meters below the ground. It’s the most secure way of providing help to our injured military personnel. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of enemy FPV drones, which drop grenades with lethal accuracy. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. It’s an era of drones and a different kind of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean facility for treating wounded soldiers in eastern Ukraine.

On one day recently, a group of three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a minor wound in his leg. “War is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Subsequently the enemy forces released a second explosive on him.” He continued: “Everything in the village is destroyed. There are drones all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit endured over a month in a wooded zone close to the city, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. Necessary provisions arrived by quadcopter: food and drinking water. Seven days following he was hurt, he walked 5km (roughly three miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone ripped a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he said. “I think I was lucky to survive. A relative has been lost. We face ongoing detonations.” A builder employed in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve days before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, removed a bloody bandage and cleaned his two-day-old injury from fragments. Covered in a foil blanket, he used a mobile phone to ring his sister. “A fragment of artillery struck me. It was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a several months. After that, to go back to my military group. Our forces must protect our country,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, earth and granular material laid on top up to the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 facilities in total. A senior official of the nation's national security council and former defence minister, the official, said they would be “critically important for preserving the survival of our armed forces and supporting defenders on the battlefront.” The company described the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

An example of the centre’s operating theatres.

The surgeon, said certain wounded personnel had to endure delays many hours or even multiple days before they could be transported due to the danger of air assaults. “We had two critically ill patients who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no other option.” How did he cope with severe operations? “My career in medicine for two decades. One must concentrate,” he said.

Medical assistants wheeled the soldier through the passage and into an ambulance. The vehicle was stationed under a bush. He and the two other military members were transferred to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked up to the entrance to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko said. “It doesn’t stop.”