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Sparse foliage conceal the entrance. One sloping wooden passageway leads down to a brightly lit reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, drugs and organized stacks of extra garments. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. The screen reveals the movements of enemy surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground hospital look at a monitor displaying enemy suicide and reconnaissance drones in the region.

This is the nation's covert underground hospital. This center began operations in August and is the second of its kind, located in eastern Ukraine close to the combat zone and the urban area of a key location in Donetsk oblast. “We are six meters below the earth. This is the most secure method of delivering care to our injured military personnel. And it keeps medical personnel protected,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a day. Their conditions vary. Some have catastrophic limb trauma necessitating amputations, or severe stomach wounds. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) drones, which drop grenades 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 conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for injured soldiers in eastern Ukraine.

During one day last week, three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Subsequently the Russians dropped a second grenade on him.” He added: “Everything in the village is demolished. There are drones all around and casualties. Our side's and theirs.”

Dvorskyi said his unit spent 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. Necessary provisions arrived by quadcopter: food and drinking water. Seven days following he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to a point where an military transport was able to pick him up. Upon arrival, a medic assessed his physical condition. Following care, a nurse gave him fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

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

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it became black. 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 detonations.” A builder working in a neighboring country, he said he had returned to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a stained bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of artillery hit me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my military group. Our forces has to protect our nation,” he said.

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

Since 2022, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. Per international monitors, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is built from multiple steel bunkers, with timber beams, soil and sand placed above reaching ground level. It is designed to resist impacts from large-caliber artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

A major industrial group, which financed the building, intends to build twenty units in total. The head of the nation's security agency and former defence minister, Rustem Umerov, said they would be “vitally essential for preserving the survival of our armed forces and supporting defenders on the battlefront.” The company referred to the project as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

One of the centre’s operating theatres.

The surgeon, said some wounded personnel had to wait many hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “We had a pair of critically ill patients who arrived at the early hours. It was necessary to carry out a double amputation on one of them. The soldier's bleeding control device had been on for so long there was no other option.” What is his method with traumatic operations? “My career in healthcare for two decades. One must focus,” he remarked.

Orderlies transported Mykolaichuk up the tunnel and into an emergency vehicle. The transport was stationed under a shrub. The patient and the other military members were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, the mascot, walked up to the doorway to greet the next arrivals. “We are active 24 hours a day,” the surgeon stated. “The work is continuous.”