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Sparse trees conceal the entryway. A sloping wooden tunnel descends to a well-illuminated welcome zone. Inside lies a operating ward, equipped with gurneys, heart rate sensors and ventilators. And shelves full of healthcare supplies, medications and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital staff at an subterranean medical center look at a screen showing enemy suicide and surveillance UAVs in the area.

This is Ukraine’s covert underground medical facility. This center opened in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the city of a key location in the Donetsk region. “We are six meters under the earth. This is the safest method of delivering care to our wounded military personnel. And it keeps medical personnel safe,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter few bullet injuries. This is an era of drones and a new type of war,” the doctor explained.

Major the senior surgeon at the underground facility for treating injured troops in the eastern region.

On one day recently, three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a minor wound in his leg. “Conflict is terrible. My comrade next to me, Vasyl, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces released a another grenade on him.” He continued: “All structures in the settlement is demolished. We see UAVs everywhere and bodies. Ours and the enemy's.”

The soldier said his squad spent 43 days in a wooded zone close to the city, which enemy forces has been attempting to capture for many months. The only way to reach their position was on foot. All supplies came by quadcopter: food and drinking water. A week after he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to where an military transport was able to evacuate him. Upon arrival, a medic checked his vital signs. Following care, a medical attendant gave him fresh civilian clothes: a shirt and a set of pale jeans.

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

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “I was in a trench shelter. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face ongoing explosions.” A builder employed in Lithuania, he noted he had returned to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a bed, removed a stained dressing and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to call his sister. “A fragment of artillery hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a few months. After that, to go back to my military group. Someone has to defend our country,” he said.

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

Since 2022, Russia has consistently targeted hospitals, clinics, obstetric units and ambulances. According to human rights groups, 261 health workers have been fatally attacked in almost two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and granular material placed above up to ground level. It is designed to resist impacts from large-caliber projectiles and even three 8kg TNT charges dropped by aerial means.

A major steel and mining company, which funded the building, plans to build 20 units in total. A senior official of the nation's national security council and ex- defence minister, Rustem Umerov, said they would be “vitally important for preserving the lives of our military and supporting defenders on the battlefront.” The organization referred to the project as the “most ambitious and demanding” it had undertaken after the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, said some wounded soldiers had to wait many hours or even multiple days before they could be transported because of the threat of air assaults. “Our facility received two critically ill patients who arrived at the early hours. I had to carry out a double amputation on a patient. His bleeding control device had been on for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been healthcare for two decades. You have to focus,” he remarked.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked under a bush. The patient and the two other military members were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, padded up to the doorway to greet the incoming patients. “We are active 24 hours a day,” Holovashchenko said. “The work is continuous.”