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Scrubby trees conceal the entrance. A descending wooden passageway leads down to a well-illuminated reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. Plus shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, doctors monitor a screen. It shows the movements of enemy surveillance UAVs as they zigzag in the air above.

Hospital staff at an underground hospital observe a monitor showing enemy suicide and surveillance drones in the region.

This is the nation's secret below-ground hospital. The facility began operations in August and is the second such installation, located in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. This is the most secure method of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have devastating leg injuries requiring amputations, or severe stomach wounds. Others can walk. The vast majority are the casualties of Russian FPV drones, which drop explosives with lethal precision. “90% of our cases are from FPVs. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a different kind of war,” the doctor said.

Maj Oleksandr Holovashchenko at the underground installation for caring for wounded troops in eastern Ukraine.

On one afternoon recently, a group of three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an FPV explosion had torn a minor wound in his limb. “Conflict is horrific. My comrade next to me, a fellow soldier, was killed,” he stated. “He fell down. Subsequently the Russians dropped a another grenade on him.” He continued: “All structures in the village is destroyed. We see UAVs everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his unit endured over a month in a forest area near the city, which Russia has been attempting to capture since last year. The only way to reach their location was by walking. Necessary provisions came by quadcopter: rations and drinking water. A week following he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. Following care, a medical attendant provided him with fresh civilian clothes: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device ripped a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, said a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he said. “I believe I was lucky to survive. A relative has been killed. There are ongoing explosions.” A builder working in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a stained bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to call his family member. “A fragment of mortar hit me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. That will take a several months. Subsequently, to return to my military group. Our forces has to protect our nation,” he said.

Medical staff care for the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Since 2022, enemy forces has consistently targeted medical centers, health facilities, maternity wards and ambulances. Per human rights groups, 261 health workers have been killed in nearly two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, soil and sand placed above reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple eight-kilogram explosive devices released by drone.

A major steel and mining company, which funded the construction, plans to build twenty facilities in all. A senior official of Ukraine’s national security council and former military leader, the official, said they would be “vitally essential for preserving the survival of our military and supporting troops on the frontline.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented after Russia’s military offensive.

One of the facility's surgical rooms.

Holovashchenko, said certain injured soldiers had to endure delays hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had a pair of severely injured casualties who arrived at the early hours. I had to carry out a double amputation on a patient. The soldier's bleeding control device had been applied for so long there was no other option.” What is his method with traumatic surgeries? “I’ve been healthcare for two decades. One must focus,” he said.

Medical assistants transported the soldier through the passage and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the two other soldiers were taken to the city of a major city for additional medical care. The underground hospital staff took a break. The facility's orange feline, Vasilevs, padded toward the doorway to greet the incoming patients. “We are active 24 hours a day,” the surgeon stated. “It doesn’t stop.”