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Sparse foliage hide the entryway. One descending timber passageway descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, drugs and neat piles of extra garments. Within a staff room with a laundry appliance and hot water heater, doctors keep an eye on a screen. It shows the movements of enemy surveillance UAVs as they weave in the air above.

Hospital personnel at an underground medical center observe a screen displaying Russian suicide and reconnaissance drones in the area.

This is the nation's secret below-ground medical facility. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits six meters under the earth. This is the most secure way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 casualties a day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of Russian FPV aerial devices, which drop explosives with deadly precision. “90% of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor said.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded soldiers in eastern Ukraine.

On one day last week, three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had ripped a small hole in his leg. “War is terrible. The guy next to me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the Russians released a second explosive on him.” He continued: “Everything in the settlement is demolished. We see UAVs all around and bodies. Ours and the enemy's.”

Dvorskyi said his unit spent 43 days in a forest area near the city, which enemy forces has been trying to seize for many months. Sole access to get to their position was on foot. All supplies came by drone: food and drinking water. A week after he was injured, he traveled 5km (about 3 miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his physical condition. Following care, a medical attendant gave him new non-military attire: a T-shirt and a pair of light-colored denim trousers.

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

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it became black. I lost sensation anything or any sound,” he said. “I think I was fortunate to survive. A relative has been killed. There are continuous detonations.” A builder working in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors placed him on a bed, took off a stained dressing and treated his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his sister. “A fragment of mortar hit me. It was a ricochet. My condition is stable,” 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 must protect our nation,” he said.

Doctors care for the wounded soldier, who was injured in the back by a fragment of mortar.

Since 2022, Russia has consistently attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, over two hundred medical personnel have been killed in almost 2,000 assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, soil and sand laid on top reaching the surface. It is designed to resist impacts from large-caliber projectiles and even multiple 8kg explosive devices dropped by aerial means.

The Ukrainian industrial group, which funded the building, intends to erect 20 facilities in all. The head of the nation's security agency and ex- defence minister, the official, said they would be “critically essential for preserving the survival of our military and supporting defenders on the battlefront.” The company described the project as the “largest-scale and demanding” it had undertaken since Russia’s military offensive.

One of the facility's surgical rooms.

The surgeon, explained certain wounded soldiers had to wait many hours or even multiple days before they could be transported due to the danger of aerial attacks. “We had a pair of severely injured casualties who came at the early hours. It was necessary to perform a double amputation on a patient. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. One must concentrate,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The transport was stationed under a shrub. The patient and the other soldiers were taken to the city of a major city for further treatment. The subterranean medical team took a break. The hospital’s orange feline, Vasilevs, walked toward the doorway to greet the incoming patients. “Our facility operates active around the clock,” the surgeon stated. “It doesn’t stop.”