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Scrubby trees hide the entryway. One sloping wooden tunnel descends to a brightly lit welcome zone. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets full of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a washing machine and kettle, physicians monitor a screen. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Hospital staff at an underground medical center observe a screen displaying Russian kamikaze and surveillance UAVs in the area.

Welcome to Ukraine’s covert below-ground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits six meters below the earth. This is the most secure way of providing help to our injured military personnel. And it keeps medical personnel protected,” said the facility's lead doctor, Major the chief surgeon.

The stabilisation point treats 30-40 patients a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma necessitating amputations, or severe stomach wounds. Others can walk. Almost all are the victims of enemy FPV aerial devices, which release explosives with deadly precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an age of drones and a different kind of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the subterranean installation for treating injured soldiers in the eastern region.

During one afternoon recently, a group of three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his limb. “War is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a second explosive on him.” He continued: “All structures in the village is demolished. There are UAVs everywhere and bodies. Ours and theirs.”

Dvorskyi explained his squad endured over a month in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to reach their location was by walking. Necessary provisions arrived by drone: food and drinking water. A week following he was hurt, he traveled 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his physical condition. After treatment, a nurse gave him new civilian clothes: a shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a first-person view drone ripped a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to survive. My cousin has been lost. There are continuous detonations.” A construction worker employed in a neighboring country, he noted he had returned to his homeland and enlisted to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a stained bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. That will take a several months. After that, to go back to my unit. Someone must defend our country,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a piece of mortar.

Over the past years, Russia has consistently targeted hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is built from multiple steel bunkers, with timber beams, earth and granular material laid on top reaching the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple eight-kilogram explosive devices dropped by drone.

The Ukrainian steel and mining company, which funded the building, intends to build twenty units in total. A senior official of Ukraine’s security agency and ex- defence minister, the official, declared they would be “critically important for preserving the survival of our military and assisting defenders on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had undertaken since the enemy's invasion.

An example of the facility's operating theatres.

The surgeon, said certain wounded personnel had to endure delays hours or even days before they could be transported because of the threat of aerial attacks. “We had a pair of severely injured patients who came at the early hours. I had to carry out a double amputation on a patient. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for 20 years. One must focus,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an ambulance. The transport was parked under a shrub. The patient and the two other military members were transferred to the city of a major city for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, walked up to the entrance to greet the next arrivals. “We are active around the clock,” Holovashchenko said. “The work is continuous.”