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Scrubby foliage hide the entryway. One descending timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and breathing machines. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground hospital observe a screen displaying Russian kamikaze and reconnaissance drones in the region.

This is the nation's secret below-ground medical facility. The facility began operations in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits six meters under the earth. It’s the safest method of delivering care to our wounded military personnel. It also ensures medical personnel safe,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have devastating leg injuries necessitating amputations, or severe stomach wounds. Others can walk. Almost all are the victims of Russian FPV aerial devices, which drop grenades with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter few gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded troops in eastern Ukraine.

During one afternoon last week, three military members limped into the facility. The least severely hurt, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Subsequently the enemy forces released a second grenade on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone near the city, which enemy forces has been attempting to capture for many months. Sole access to reach their location was by walking. Necessary provisions arrived by quadcopter: food and water. Seven days following he was hurt, he traveled five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. Following care, a nurse provided him with fresh civilian clothes: a shirt and a pair of pale jeans.

The soldier, twenty-eight, said a FPV drone caused a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “My position was in a dugout. It suddenly became black. I lost sensation anything or hear anything,” he explained. “I think I was fortunate to survive. My cousin has been lost. We face ongoing explosions.” A construction worker employed in a neighboring country, he said he had returned to his homeland and enlisted to fight shortly before the Russian leader's large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as doctors laid him on a bed, removed a stained bandage and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of mortar struck me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. This may require a few months. After that, to go back to my military group. Someone has to defend our nation,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the dorsal area by a piece of mortar.

Since 2022, enemy forces has consistently attacked hospitals, clinics, maternity wards and ambulances. According to human rights groups, 261 medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and sand placed above reaching ground level. It can withstand direct hits from 152mm projectiles and even multiple 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 units in all. A senior official of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “critically important for saving the survival of our armed forces and assisting troops on the battlefront.” The company described the initiative as the “largest-scale and challenging” it had implemented after the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said some wounded personnel had to endure delays many hours or even days before they could be transported because of the threat of aerial attacks. “We had a pair of critically ill casualties who came at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no other option.” What is his method with severe surgeries? “My career in healthcare for 20 years. One must focus,” he remarked.

Orderlies transported Mykolaichuk up the tunnel and into an ambulance. The vehicle was stationed beneath 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 hospital’s ginger cat, Vasilevs, padded up to the entrance to await the next arrivals. “We are active 24 hours a day,” the surgeon stated. “It doesn’t stop.”