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Scrubby foliage hide the entrance. A sloping timber tunnel descends to a brightly lit welcome zone. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus cabinets full of medical equipment, drugs and organized stacks of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital staff at an subterranean hospital observe a screen displaying enemy kamikaze and surveillance drones in the region.

This is Ukraine’s secret underground medical facility. The facility opened in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres below the ground. It’s the most secure method of delivering care to our injured soldiers. It also ensures healthcare workers protected,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty patients a each day. Cases differ widely. Some have devastating leg injuries requiring amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly accuracy. “90% of our patients are from first-person view drones. We see minimal bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the doctor said.

Major the senior surgeon at the underground installation for treating injured troops in eastern Ukraine.

During one afternoon last week, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone explosion had torn a small hole in his leg. “Conflict is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the settlement is destroyed. There are UAVs all around and bodies. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a wooded zone near the city, which Russia has been attempting to capture for many months. The only way to get to their location was by walking. All supplies arrived by quadcopter: food and drinking water. Seven days after he was hurt, he walked 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his vital signs. After treatment, a nurse provided him with fresh civilian clothes: a T-shirt and a pair of pale jeans.

The soldier, 28, said a first-person view aerial device caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel anything or any sound,” he explained. “I think I was fortunate to survive. My cousin has been lost. There are ongoing detonations.” A construction worker working in a neighboring country, he noted he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as doctors placed him on a medical cot, took off a stained dressing and treated his recent shrapnel wound. Covered in a thermal sheet, he used a cellphone to call his family member. “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. This may require a several months. After that, to go back to my unit. Our forces must defend our nation,” he said.

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

Over the past years, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. Per international monitors, 261 medical personnel have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple reinforced shelters, with timber beams, soil and sand placed above 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.

A major industrial group, which funded the building, intends to erect 20 units in total. A senior official of Ukraine’s national security council and former defence minister, Rustem Umerov, said they would be “vitally important for saving the lives of our military and supporting troops on the frontline.” The company referred to the project as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, explained some injured soldiers had to endure delays many hours or even multiple days before they could be evacuated due to the threat of air assaults. “Our facility received two critically ill patients who arrived at the early hours. I had to carry out a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no other option.” What is his method with severe surgeries? “I’ve been medicine for two decades. One must concentrate,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the other soldiers were taken to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The facility's orange feline, Vasilevs, padded toward the entrance to greet the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko stated. “The work is continuous.”