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Sparse trees hide the entrance. One descending timber passageway descends to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. And cabinets full of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a washing machine and kettle, physicians keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the air above.

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

Welcome to the nation's secret underground hospital. The facility began operations in August and is the second of its kind, located in the eastern part of the country not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits six meters below the ground. It’s the safest method of delivering care to our injured military personnel. It also ensures healthcare workers safe,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian FPV drones, which drop grenades with lethal accuracy. “90% of our cases are from FPVs. We see few gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the doctor explained.

Major Oleksandr Holovashchenko at the underground facility for caring for injured troops in eastern Ukraine.

On one day recently, a group of three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had torn a small hole in his leg. “War is terrible. My comrade next to me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians dropped a second explosive on him.” He added: “Everything in the settlement is demolished. There are UAVs all around and casualties. Ours and the enemy's.”

The soldier said his unit spent 43 days in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies arrived by drone: rations and water. A week following he was hurt, he traveled five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, 28, said a first-person view aerial device ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to survive. My cousin has been lost. We face ongoing detonations.” A construction worker working in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a bed, took off a bloody bandage and cleaned his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to call his sister. “A fragment of mortar 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. Subsequently, to return to my military group. Our forces has to defend our country,” he affirmed.

Doctors treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Over the past years, Russia has consistently targeted medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, over two hundred medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and granular material placed above up to the surface. It can withstand impacts from large-caliber artillery shells and even three eight-kilogram explosive devices released by aerial means.

A major steel and mining company, which funded the building, plans to build 20 units in all. The head of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for preserving the lives of our armed forces and assisting defenders on the frontline.” The company described the initiative as the “most ambitious and challenging” it had undertaken since Russia’s invasion.

One of the facility's operating theatres.

The surgeon, explained certain injured personnel had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had two severely injured patients who arrived at 3am. It was necessary to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no alternative.” What is his method with severe surgeries? “I’ve been healthcare for 20 years. One must focus,” he said.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. He and the two other military members were taken to the city of Dnipro for further treatment. The underground medical team paused for rest. The facility's orange feline, the mascot, walked up to the doorway to greet the incoming patients. “Our facility operates active around the clock,” Holovashchenko said. “The work is continuous.”