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Scrubby foliage hide the entrance. One sloping timber passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. Plus cabinets stocked of medical equipment, drugs and organized stacks of spare clothes. In a staff room with a washing machine and kettle, physicians monitor a screen. It shows the movements of Russian spy drones as they weave in the sky above.

Medical personnel at an underground hospital observe a screen displaying Russian suicide and surveillance UAVs in the region.

This is Ukraine’s secret below-ground 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. “We are 6 metres under the earth. This is the safest method of providing help to our injured military personnel. And it keeps healthcare workers protected,” said the facility's lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a each day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We see few gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the surgeon said.

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

During one day last week, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a minor wound in his leg. “War is horrific. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Then the Russians released a second explosive on him.” He added: “Everything in the settlement is demolished. We see UAVs all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit endured 43 days in a wooded zone close to the city, which enemy forces has been attempting to capture since last year. Sole access to get to their position was by walking. All supplies came by quadcopter: rations and drinking water. Seven days following he was injured, he walked 5km (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a medical attendant gave him new non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone caused a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “I was in a dugout. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I believe I was lucky to remain alive. A relative has been lost. We face ongoing detonations.” A construction worker working in a neighboring country, Filipchuk noted he had come back to his homeland and volunteered to serve days before Vladimir Putin’s large-scale attack 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, took off a stained bandage and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a cellphone to ring his sister. “A piece of artillery struck me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Our forces has to protect our nation,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been killed in almost two thousand assaults. The underground facility is built from four reinforced shelters, with wooden supports, earth and sand placed above up to the surface. It is designed to resist impacts from 152mm projectiles and even three 8kg explosive devices released by aerial means.

The Ukrainian industrial group, which funded the construction, intends to build 20 facilities in total. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, said they would be “vitally important for preserving the survival of our military and assisting troops on the frontline.” The organization referred to the initiative as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said certain wounded soldiers had to endure delays hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received two severely injured casualties who arrived at the early hours. I had to carry out a double amputation on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been healthcare for two decades. One must concentrate,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an emergency vehicle. The vehicle was stationed under a bush. He and the other soldiers were taken to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, walked toward the doorway to await the incoming patients. “Our facility operates open around the clock,” the surgeon said. “It doesn’t stop.”