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Scrubby trees conceal the entryway. One sloping wooden tunnel descends to a brightly lit welcome zone. There is a operating ward, outfitted with gurneys, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a washing machine and kettle, physicians monitor a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital observe a monitor displaying Russian suicide and surveillance UAVs in the area.

This is Ukraine’s covert below-ground medical facility. The facility began operations in the eighth month and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. This is the most secure method of providing help to our wounded military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Some have devastating leg injuries necessitating amputations, or serious stomach wounds. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with lethal accuracy. “90% of our cases are from first-person view drones. We encounter minimal bullet injuries. It’s an era of drones and a new type of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for injured troops in the eastern region.

During one day recently, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his limb. “War is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the Russians released a second grenade on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

Dvorskyi said his unit spent over a month in a wooded zone close to the city, which Russia has been attempting to capture since last year. The only way to get to their position was on foot. All supplies arrived by quadcopter: rations and water. A week after he was hurt, he traveled five kilometers (about 3 miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic checked his vital signs. Following care, a medical attendant gave him fresh non-military attire: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device caused a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous detonations.” A construction worker employed in Lithuania, he noted he had returned to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as medical staff laid him on a medical cot, took off a stained bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his family member. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my unit. Someone has to protect our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a piece of artillery shell.

Over the past years, Russia has consistently attacked hospitals, clinics, maternity wards and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in almost two thousand attacks. The underground facility is constructed from four steel bunkers, with timber beams, earth and granular material laid on top reaching ground level. It can withstand impacts from large-caliber projectiles and even multiple eight-kilogram explosive devices dropped by drone.

The Ukrainian industrial group, which funded the building, plans to build twenty units in all. The head of Ukraine’s national security council and ex- military leader, the official, said they would be “vitally essential for saving the lives of our armed forces and assisting defenders on the frontline.” The organization referred to the project as the “largest-scale and demanding” it had undertaken after the enemy's military offensive.

An example of the centre’s operating theatres.

The surgeon, explained some wounded soldiers had to wait many hours or even days before they could be evacuated because of the danger of aerial attacks. “Our facility received a pair of severely injured casualties who came at 3am. I had to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for such an extended period there was no other option.” How did he cope with severe operations? “I’ve been medicine for two decades. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an ambulance. The vehicle was parked under a bush. The patient and the other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The hospital’s orange feline, the mascot, padded up to the entrance to await the next arrivals. “We are open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”