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Sparse foliage hide the entrance. One descending wooden passageway descends to a brightly lit welcome zone. There is a operating ward, equipped with beds, heart rate sensors and ventilators. And 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 display. It shows the movements of enemy surveillance UAVs as they weave in the air above.

Medical personnel at an underground hospital observe a monitor showing enemy suicide and surveillance drones in the area.

Welcome to Ukraine’s secret underground medical facility. The facility began operations in the eighth month and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the most secure way of delivering care to our wounded military personnel. And it keeps healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 casualties a day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or severe stomach wounds. Others can walk. The vast majority are the casualties of Russian FPV aerial devices, which drop explosives with deadly accuracy. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the underground facility for treating wounded soldiers in eastern Ukraine.

On one afternoon recently, three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his limb. “War is horrific. My comrade next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces dropped a second explosive on him.” He added: “Everything in the village is destroyed. We see UAVs all around and bodies. Ours and theirs.”

The soldier said his squad endured 43 days in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to get to their position was on foot. All supplies arrived by quadcopter: rations and water. A week after he was hurt, he traveled five kilometers (about 3 miles), requiring several hours, to where an military transport was able to pick him up. At the clinic, a medic checked his vital signs. Following care, a nurse gave him new civilian clothes: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV drone caused 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. “My position was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. A relative has been killed. We face ongoing explosions.” A builder working in Lithuania, he said he had come back to his homeland and volunteered to fight days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors placed him on a medical cot, took off a bloody bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A piece of artillery hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my military group. Someone must protect our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Since 2022, Russia has repeatedly attacked hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, over two hundred health workers have been killed in nearly two thousand assaults. The underground facility is built from four reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It is designed to resist impacts from 152mm projectiles and even three eight-kilogram TNT charges dropped by drone.

A major industrial group, which funded the building, intends to erect 20 units in all. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “critically essential for preserving the lives of our armed forces and assisting troops on the frontline.” The organization described the project as the “largest-scale and challenging” it had undertaken since Russia’s military offensive.

An example of the centre’s operating theatres.

The surgeon, explained some injured soldiers had to endure delays many hours or even multiple days before they could be evacuated due to the threat of air assaults. “We had two critically ill casualties who came at 3am. It was necessary to carry out a removal of both limbs on a patient. His bleeding control device had been on for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for 20 years. You have to focus,” he said.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked beneath a bush. The patient and the two other soldiers were transferred to the urban center of a major city for additional medical care. The underground medical team paused for rest. The facility's ginger cat, the mascot, walked toward the entrance to greet the incoming patients. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”