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Scrubby foliage hide the entryway. One sloping wooden tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus shelves stocked of medical equipment, medications and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, physicians monitor a display. It shows the movements of enemy spy drones as they zigzag in the air above.

Hospital personnel at an underground medical center observe a monitor displaying Russian suicide and surveillance UAVs in the region.

This is the nation's secret below-ground hospital. The facility began operations in the eighth month and is the second such installation, situated in the eastern part of the country close to the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres under the earth. This is the safest way of delivering care to our injured soldiers. And it keeps medical personnel safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) drones, which release explosives with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We see minimal bullet injuries. This is an era of drones and a new type of conflict,” the surgeon said.

Maj the senior surgeon at the underground installation for caring for injured troops in eastern Ukraine.

During one day recently, three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old one soldier, said an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the enemy forces released a second explosive on him.” He continued: “All structures in the village is demolished. We see UAVs all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture since last year. The only way to reach their position was by walking. All supplies came by quadcopter: rations and water. A week following he was hurt, he walked five kilometers (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a nurse provided him with new non-military attire: a shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view drone ripped a minor injury in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel any feeling or hear anything,” he said. “I think I was lucky to remain alive. My cousin has been lost. There are ongoing explosions.” A construction worker employed in a neighboring country, Filipchuk noted he had returned to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as doctors laid him on a bed, removed a bloody bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a mobile phone to call his sister. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To get better. This may require a several months. After that, to go back to my unit. Someone has to defend our nation,” he affirmed.

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

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist direct hits from large-caliber projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian steel and mining company, which funded the construction, intends to build twenty facilities in all. The head of the nation's security agency and former defence minister, the official, said they would be “critically important for preserving the survival of our military and supporting defenders on the frontline.” The company referred to the initiative as the “largest-scale and demanding” it had implemented after the enemy's military offensive.

One of the facility's surgical rooms.

The surgeon, explained some wounded personnel had to wait many hours or even days before they could be transported due to the danger of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to perform a double amputation on one of them. The soldier's 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 transported Mykolaichuk up the passage and into an emergency vehicle. The transport was parked beneath a shrub. He and the other military members were transferred to the city of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s ginger cat, Vasilevs, walked toward the doorway to await the incoming patients. “We are open 24 hours a day,” Holovashchenko said. “The work is continuous.”