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Scrubby foliage hide the entryway. One sloping wooden passageway descends to a well-illuminated reception area. There is a operating ward, outfitted with beds, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a washing machine and kettle, physicians monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an subterranean hospital look at a monitor showing Russian suicide and surveillance UAVs in the region.

Welcome to the nation's secret below-ground hospital. This center opened in August and is the second of its kind, situated in eastern Ukraine close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits six meters below the ground. It’s the safest method of delivering care to our injured soldiers. And it keeps healthcare workers protected,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the victims of enemy FPV aerial devices, which drop explosives with lethal accuracy. “90% of our patients are from FPVs. We see few bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for wounded soldiers in the eastern region.

On one day last week, three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a small hole in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he stated. “He fell down. Subsequently the enemy forces dropped a another explosive on him.” He continued: “Everything in the settlement is demolished. There are UAVs all around and casualties. Ours and theirs.”

The soldier said his unit endured 43 days 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. Necessary provisions came by drone: rations and drinking water. A week after he was hurt, he walked 5km (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his physical condition. Following care, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, stated a FPV aerial device caused a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to remain alive. My cousin has been killed. We face ongoing explosions.” A builder employed in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as doctors laid him on a bed, removed a bloody bandage and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A fragment of artillery struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. That will take a few months. Subsequently, to go back to my unit. Our forces has to defend our country,” he said.

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

Since 2022, Russia has repeatedly attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It can withstand direct hits from 152mm projectiles and even multiple eight-kilogram explosive devices released by drone.

The Ukrainian steel and mining company, which funded the construction, intends to erect 20 units in all. A senior official of the nation's national security council and ex- defence minister, the official, declared they would be “critically essential for preserving the survival of our military and supporting defenders on the battlefront.” The organization described the initiative as the “largest-scale and demanding” it had undertaken since Russia’s invasion.

An example of the centre’s surgical rooms.

The surgeon, explained some injured personnel had to endure delays many hours or even multiple days before they could be transported due to the threat of air assaults. “Our facility received a pair of critically ill casualties who came at 3am. It was necessary to carry out a double amputation on a patient. The soldier's tourniquet had been on for such an extended period there was no other option.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. You have to focus,” he remarked.

Medical assistants transported Mykolaichuk through the passage and into an ambulance. The vehicle was stationed beneath a bush. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, the mascot, walked up to the entrance to await the incoming patients. “We are open around the clock,” Holovashchenko stated. “The work is continuous.”