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Sparse trees conceal the entryway. A descending timber passageway descends to a well-illuminated reception area. There is a surgery unit, equipped with beds, heart rate sensors and breathing machines. And shelves full of medical equipment, medications and neat piles of extra garments. In a break area with a laundry appliance and hot water heater, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital personnel at an underground medical center observe a monitor displaying Russian kamikaze and surveillance drones in the area.

Welcome to the nation's covert underground medical facility. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits six meters under the ground. This is the most secure way of providing help to our wounded soldiers. And it keeps healthcare workers protected,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 casualties a day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or serious abdominal injuries. Others can move on their own. Almost all are the casualties of Russian FPV aerial devices, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We encounter minimal gunshot wounds. It’s an age of drones and a new type of conflict,” the doctor said.

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

During one day last week, a group of three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a minor wound in his leg. “Conflict is horrific. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Then the Russians dropped a another grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs everywhere and bodies. Ours and theirs.”

Dvorskyi explained his squad spent over a month in a forest area near the city, which enemy forces has been attempting to capture for many months. Sole access to get to their location was by walking. All supplies arrived by drone: rations and water. Seven days following he was hurt, he walked 5km (roughly three miles), requiring several hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a medical attendant provided him with new civilian clothes: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device ripped a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in concussion. “My position was in a trench shelter. It suddenly 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 ongoing explosions.” A construction worker working in a neighboring country, Filipchuk said he had returned to his homeland and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as doctors placed him on a medical cot, took off a stained dressing and cleaned his two-day-old injury from fragments. Covered in a foil blanket, he borrowed a cellphone to call his sister. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To get better. This may require a several months. Subsequently, to go back to my military group. Our forces must protect our country,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been killed in almost two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and granular material placed above reaching the surface. It can withstand direct hits from large-caliber artillery shells and even multiple 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect 20 facilities in all. A senior official of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “critically essential for preserving the survival of our armed forces and supporting defenders on the frontline.” The company described the project as the “largest-scale and challenging” it had undertaken since the enemy's military offensive.

One of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to wait hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received a pair of critically ill patients who arrived at 3am. I had to perform a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the passage and into an emergency vehicle. The vehicle was parked under a bush. He and the other soldiers were transferred to the urban center of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, the mascot, padded up to the entrance to await the next arrivals. “We are active 24 hours a day,” Holovashchenko said. “The work is continuous.”