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Scrubby trees hide the entryway. One descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. Plus cabinets full of medical equipment, drugs and neat piles of spare clothes. In a break area with a washing machine and kettle, doctors monitor a display. The screen reveals the movements of Russian spy drones as they weave in the air above.

Hospital staff at an underground medical center observe a monitor displaying enemy suicide and reconnaissance drones in the area.

This is Ukraine’s covert underground hospital. This center opened in August and is the second of its kind, located in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “Our facility sits 6 metres below the earth. This is the most secure way of providing help to our injured soldiers. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. The vast majority are the victims of Russian first-person view (FPV) drones, which release explosives with deadly precision. “90% of our patients are from first-person view drones. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for treating injured soldiers in the eastern region.

On one day last week, three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “War is horrific. My comrade next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a second grenade on him.” He added: “Everything in the village is destroyed. There are drones all around and casualties. Ours and the enemy's.”

The soldier explained his unit endured over a month in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to reach their position was on foot. All supplies arrived by quadcopter: rations and drinking water. A week after he was hurt, he walked five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. At the clinic, a medic assessed his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale jeans.

Artem Dvorskiy, 28, said a FPV drone caused a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I lost sensation anything or any sound,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. We face continuous explosions.” A builder working in a neighboring country, he noted he had come back to Ukraine and volunteered to fight days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a bloody dressing and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of artillery hit me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. After that, to return to my military group. Someone has to protect our country,” he affirmed.

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

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple steel bunkers, with timber beams, earth and sand laid on top reaching ground level. It can withstand direct hits from 152mm projectiles and even multiple eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which financed the building, plans to erect 20 facilities in total. The head of the nation's security agency and former defence minister, the official, said they would be “vitally important for saving the survival of our military and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and challenging” it had implemented after Russia’s invasion.

One of the facility's operating theatres.

The surgeon, explained some wounded soldiers had to endure delays many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “We had a pair of critically ill casualties who came at 3am. It was necessary to perform a removal of both limbs on a patient. His bleeding control device had been on for such an extended period there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. You have to focus,” he said.

Orderlies wheeled the soldier up the passage and into an ambulance. The transport was parked beneath a bush. He and the other military members were taken to the city of a major city for additional medical care. The subterranean hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to greet the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”