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Sparse trees conceal the entrance. One sloping wooden tunnel descends to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus shelves full of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a laundry appliance and hot water heater, doctors keep an eye on a screen. It shows the flight patterns of enemy spy drones as they weave in the sky above.

Hospital staff at an underground hospital observe a monitor showing enemy kamikaze and surveillance drones in the area.

Welcome to the nation's secret underground hospital. This center began operations in August and is the second such installation, located in the eastern part of the country close to the combat zone and the urban area of a key location in Donetsk oblast. “We are six meters under the ground. It’s the most secure method of providing help to our injured military personnel. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point treats 30-40 casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an age of drones and a different kind of war,” the doctor said.

Maj the senior surgeon at the subterranean facility for caring for injured soldiers in the eastern region.

During one afternoon last week, three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the Russians released a second explosive on him.” He continued: “All structures in the village is destroyed. We see UAVs everywhere and bodies. Ours and the enemy's.”

The soldier said his squad endured 43 days in a forest area close to the city, which enemy forces has been attempting to capture since last year. Sole access to get to their position was by walking. All supplies came by drone: rations and drinking water. Seven days following he was hurt, he traveled 5km (roughly three miles), taking several hours, to where an military transport was able to pick him up. At the clinic, a medical staff checked his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a first-person view drone caused a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was lucky to survive. My cousin has been killed. We face ongoing explosions.” A construction worker employed in Lithuania, Filipchuk said he had come back to his homeland and volunteered to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors laid him on a medical cot, took off a stained bandage and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A fragment of mortar struck me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. Subsequently, to return to my unit. Someone has to protect our country,” he affirmed.

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

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, obstetric units and ambulances. Per international monitors, 261 medical personnel have been fatally attacked in almost two thousand attacks. The underground facility is constructed from multiple steel bunkers, with wooden supports, earth and granular material laid on top reaching ground level. It is designed to resist impacts from 152mm artillery shells and even three 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which financed the construction, plans to build twenty facilities in total. The head of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “critically important for saving the survival of our military and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had implemented after the enemy's invasion.

One of the facility's operating theatres.

The surgeon, said some wounded soldiers had to wait many hours or even days before they could be evacuated due to the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at the early hours. It was necessary to carry out a removal of both limbs on a patient. His bleeding control device had been applied for such an extended period there was no alternative.” What is his method with traumatic surgeries? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The transport was stationed under a bush. He and the two other military members were taken to the urban center of a major city for further treatment. The subterranean medical team paused for rest. The hospital’s ginger cat, the mascot, walked toward the entrance to await the next arrivals. “Our facility operates active 24 hours a day,” the surgeon stated. “It doesn’t stop.”