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Scrubby trees hide the entryway. One descending timber passageway descends to a brightly lit welcome zone. There is a operating ward, equipped with beds, cardiac monitors and ventilators. And shelves full of medical equipment, medications and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, physicians monitor a screen. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s secret underground medical facility. This center began operations in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “We are 6 metres under the earth. It’s the most secure way of providing help to our wounded soldiers. It also ensures healthcare workers safe,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a each day. Cases differ widely. Some have devastating limb trauma requiring surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with deadly precision. “Ninety per cent of our patients are from first-person view drones. We see few gunshot wounds. This is an age of drones and a new type of conflict,” the doctor explained.

Major the senior surgeon at the subterranean facility for treating injured soldiers in the eastern region.

During one afternoon last week, a group of three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a small hole in his limb. “War is horrific. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the enemy forces released a second explosive on him.” He continued: “Everything in the settlement is demolished. We see drones all around and casualties. Our side's and theirs.”

Dvorskyi said his squad spent over a month in a forest area close to the city, which enemy forces has been trying to seize since last year. Sole access to get to their position was by walking. All supplies arrived by drone: food and water. Seven days following he was injured, he traveled 5km (roughly three miles), requiring several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, said a first-person view aerial device ripped a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he explained. “I think I was lucky to survive. My cousin has been lost. There are continuous detonations.” A builder working in a neighboring country, Filipchuk noted he had returned to his homeland and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as medical staff placed him on a medical cot, took off a bloody dressing and treated his two-day-old injury from fragments. Covered in a foil blanket, he used a mobile phone to ring his sister. “A fragment of artillery hit me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. That will take a few months. Subsequently, to return to my military group. Our forces has to protect our nation,” he affirmed.

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

Over the past years, enemy forces has consistently targeted hospitals, clinics, maternity wards and ambulances. Per international monitors, over two hundred health workers have been killed in nearly 2,000 attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and sand placed above reaching the surface. It can withstand impacts from 152mm artillery shells and even three 8kg TNT charges released by drone.

A major steel and mining company, which funded the building, intends to erect twenty units in all. A senior official of Ukraine’s security agency and former military leader, the official, said they would be “vitally important for saving the lives of our military and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and demanding” it had undertaken after the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, explained some injured personnel had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had a pair of critically ill patients who came at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's tourniquet had been applied for such an extended period there was no alternative.” How did he cope with severe operations? “My career in medicine for two decades. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. He and the two other military members were taken to the urban center of a major city for further treatment. The underground medical team took a break. The hospital’s orange feline, Vasilevs, walked toward the entrance to greet the incoming patients. “Our facility operates open around the clock,” the surgeon stated. “It doesn’t stop.”