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Sparse trees conceal the entryway. A sloping timber passageway descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, heart rate sensors and ventilators. And cabinets full of healthcare supplies, medications and organized stacks of extra garments. In a staff room 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.

Medical staff at an subterranean hospital look at a screen showing enemy suicide and surveillance drones in the region.

Welcome to the nation's covert underground hospital. This center opened in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres below the earth. This is the most secure way of providing help to our wounded soldiers. It also ensures medical personnel protected,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy FPV drones, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We see few gunshot wounds. This is an era of drones and a new type of conflict,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean facility for treating injured troops in eastern Ukraine.

During one afternoon recently, a group of three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a minor wound in his limb. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a second explosive on him.” He added: “Everything in the village is destroyed. There are drones everywhere and casualties. Ours and theirs.”

Dvorskyi explained his squad spent 43 days in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to reach their position was by walking. Necessary provisions arrived by quadcopter: food and water. A week after he was injured, he traveled 5km (roughly three miles), taking three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic checked his physical condition. After treatment, a medical attendant provided him with fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

The soldier, 28, said a FPV drone ripped a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “My position was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I think I was fortunate to survive. A relative has been killed. We face continuous detonations.” A construction worker working in a neighboring country, Filipchuk said he had returned to his homeland and enlisted to serve days before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a bed, removed a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. That will take a several months. Subsequently, to go back to my military group. Our forces must defend our country,” he affirmed.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has repeatedly attacked hospitals, clinics, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been killed in almost two thousand attacks. The underground facility is built from four reinforced shelters, with wooden supports, soil and sand laid on top reaching the surface. It is designed to resist direct hits from large-caliber artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which funded the building, plans to erect twenty facilities in all. The head of the nation's security agency and former military leader, the official, declared they would be “vitally essential for preserving the lives of our military and assisting defenders on the frontline.” The organization referred to the initiative as the “most ambitious and demanding” it had undertaken since the enemy's invasion.

One of the facility's operating theatres.

The surgeon, said some wounded soldiers had to endure delays many hours or even days before they could be evacuated because of the danger of aerial attacks. “Our facility received two critically ill patients who came at 3am. I had to carry out a removal of both limbs on a patient. The soldier's tourniquet had been applied for such an extended period there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for 20 years. You have to focus,” he remarked.

Medical assistants wheeled the soldier through the passage and into an ambulance. The transport was stationed under a shrub. The patient and the other soldiers were taken to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to greet the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”