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Sparse trees hide the entrance. A sloping wooden passageway leads down to a well-illuminated reception area. There is a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus shelves full of medical equipment, medications and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, physicians keep an eye on a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Medical personnel at an underground hospital observe a monitor showing Russian suicide and reconnaissance UAVs in the region.

Welcome to Ukraine’s secret below-ground medical facility. The facility opened in August and is the second such installation, situated in the eastern part of the country close to the frontline and the city of a key location in the Donetsk region. “Our facility sits 6 metres under the earth. It’s the safest method of delivering care to our wounded soldiers. It also ensures medical personnel protected,” stated the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which release explosives with lethal accuracy. “90% of our patients are from FPVs. We see few gunshot wounds. This is an age of drones and a different kind of conflict,” the doctor explained.

Major the senior surgeon at the subterranean installation for caring for wounded soldiers in eastern Ukraine.

During one day last week, three military members limped into the hospital. The most lightly injured, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his leg. “Conflict is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He fell down. Then the Russians dropped a second explosive on him.” He added: “All structures in the settlement is demolished. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi explained his squad endured 43 days in a wooded zone near the city, which enemy forces has been attempting to capture for many months. Sole access to get to their position was on foot. All supplies came by quadcopter: food and drinking water. A week following he was hurt, he traveled 5km (about 3 miles), taking several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a first-person view drone ripped a minor injury 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. It suddenly became black. I couldn’t feel anything or hear anything,” he said. “I believe I was lucky to remain alive. A relative has been killed. We face ongoing detonations.” A builder employed in Lithuania, he said he had come back to his homeland and volunteered to fight days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been struck in the back. He groaned as medical staff placed him on a medical cot, took off a stained bandage and treated his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his sister. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to return to my unit. Someone must defend our nation,” he said.

Medical staff treat the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and ambulances. Per international monitors, over two hundred health workers have been fatally attacked in nearly two thousand assaults. The underground facility is constructed from four steel bunkers, with timber beams, soil and granular material laid on top reaching ground level. It is designed to resist direct hits from large-caliber projectiles and even multiple 8kg TNT charges released by drone.

The Ukrainian industrial group, which funded the construction, plans to build 20 units in total. The head of Ukraine’s security agency and former military leader, Rustem Umerov, said they would be “vitally essential for saving the survival of our armed forces and supporting troops on the battlefront.” The company described the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s surgical rooms.

The surgeon, explained certain wounded personnel had to endure delays hours or even days before they could be evacuated due to the danger of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to perform a double amputation on a patient. His 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. One must concentrate,” he said.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the other soldiers were transferred to the city of Dnipro for further treatment. The underground medical team paused for rest. The facility's ginger cat, Vasilevs, walked toward the doorway to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”