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Scrubby trees conceal the entrance. One descending wooden passageway descends to a brightly lit reception area. Inside lies a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the movements of Russian surveillance UAVs as they zigzag in the air above.

Hospital staff at an underground medical center look at a monitor displaying Russian suicide and surveillance UAVs in the region.

Welcome to Ukraine’s secret below-ground hospital. This center began operations in August and is the second such installation, located in the eastern part of the country 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 injured military personnel. It also ensures healthcare workers protected,” said the facility's lead doctor, Major the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Others can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly accuracy. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. It’s an age of drones and a new type of war,” the surgeon said.

Major the senior surgeon at the underground installation for caring for wounded troops in eastern Ukraine.

During one afternoon recently, a group of three military members walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, reported an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians released a another grenade on him.” He continued: “Everything in the settlement is demolished. We see UAVs all around and bodies. Our side's and the enemy's.”

The soldier explained his unit endured over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. All supplies arrived by drone: rations and drinking water. Seven days following he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his physical condition. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, 28, said a FPV drone caused a small hole in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. We face continuous explosions.” A construction worker employed in Lithuania, Filipchuk noted he had come back to his homeland and volunteered to fight days before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a bed, took off a bloody bandage and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my military group. Our forces 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, enemy forces has consistently targeted medical centers, clinics, obstetric units and ambulances. Per human rights groups, 261 medical personnel have been killed in almost two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and sand placed above reaching the surface. It can withstand impacts from 152mm artillery shells and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, plans to erect 20 units in total. The head of the nation's security agency and former military leader, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and assisting troops on the frontline.” The company described the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

One of the facility's operating theatres.

The surgeon, explained certain wounded soldiers had to wait many hours or even days before they could be transported because of the threat of aerial attacks. “Our facility received two critically ill casualties who came at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with severe surgeries? “My career in medicine for two decades. You have to focus,” he remarked.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was parked under a shrub. The patient and the other soldiers were transferred to the urban center of Dnipro for further treatment. The subterranean medical team took a break. The facility's ginger cat, Vasilevs, padded toward the entrance to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko stated. “It doesn’t stop.”