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Scrubby trees conceal the entryway. One descending wooden tunnel descends to a well-illuminated reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the sky above.

Hospital staff at an subterranean hospital look at a screen showing Russian suicide and surveillance drones in the region.

Welcome to the nation's secret below-ground medical facility. The facility began operations in August and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the safest method of delivering care to our wounded soldiers. And it keeps medical personnel protected,” stated the clinic’s surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Some have catastrophic leg injuries requiring amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) aerial devices, which release grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We encounter few bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for caring for injured troops in the eastern region.

During one afternoon last week, a group of three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his limb. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces released a second grenade on him.” He continued: “All structures in the village is demolished. There are drones all around and bodies. Our side's and theirs.”

The soldier explained his squad endured over a month in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. Necessary provisions arrived by drone: rations and drinking water. Seven days following he was injured, he walked 5km (roughly three miles), requiring several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of light-colored denim trousers.

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

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly went dark. I couldn’t feel anything or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been lost. There are continuous explosions.” A construction worker employed in a neighboring country, he said he had returned to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as doctors placed him on a bed, took off a bloody bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A piece of mortar hit me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. That will take a several months. After that, to return to my unit. Our forces has to defend our nation,” he said.

Doctors care for the wounded soldier, who was hit in the back by a fragment of mortar.

Since 2022, Russia has consistently attacked hospitals, clinics, obstetric units and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is built from four steel bunkers, with timber beams, earth and granular material laid on top up to ground level. It can withstand impacts from large-caliber projectiles and even three eight-kilogram explosive devices released by drone.

A major steel and mining company, which funded the building, intends to build 20 facilities in total. A senior official of the nation's security agency and ex- military leader, the official, said they would be “critically important for preserving the survival of our armed forces and supporting defenders on the frontline.” The company referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, said some injured personnel had to wait hours or even multiple days before they could be transported because of the threat of aerial attacks. “We had two critically ill casualties who arrived at the early hours. 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 other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the other military members were taken to the city of a major city for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, the mascot, padded up to the entrance to await the incoming patients. “We are active around the clock,” the surgeon stated. “The work is continuous.”