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Sparse trees hide the entrance. A sloping timber tunnel leads down to a well-illuminated reception area. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a break area with a washing machine and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital staff at an underground medical center observe a monitor displaying enemy kamikaze and surveillance drones in the area.

Welcome to Ukraine’s covert below-ground 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 Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the safest way of delivering care to our injured military personnel. And it keeps healthcare workers safe,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles thirty to forty casualties a day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of Russian FPV aerial devices, which drop grenades with deadly accuracy. “Ninety per cent of our patients are from FPVs. We encounter minimal gunshot wounds. It’s an era of drones and a new type of war,” the doctor said.

Major the senior surgeon at the subterranean installation for caring for injured troops in the eastern region.

During one day recently, three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an FPV explosion had ripped a minor wound in his leg. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He fell down. Then the enemy forces dropped a second explosive on him.” He added: “All structures in the village is destroyed. We see UAVs everywhere and bodies. Our side's and the enemy's.”

Dvorskyi said his unit endured over a month in a forest area close to Pokrovsk, which Russia has been trying to seize for many months. The only way to reach their position was by walking. All supplies arrived by drone: rations and drinking water. A week following he was injured, he walked 5km (roughly three miles), requiring three hours, to a point where an military transport was able to evacuate him. At the clinic, a medic checked his physical condition. Following care, a medical attendant provided him with new non-military attire: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it went dark. I couldn’t feel anything or any sound,” he said. “I believe I was lucky to survive. My cousin has been killed. There are ongoing explosions.” A builder employed in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to fight days before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff laid him on a medical cot, took off a bloody dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A fragment of mortar hit me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. After that, to go back to my military group. Our forces must defend our country,” he affirmed.

Doctors care for Taras Mykolaichuk, who was injured in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, obstetric units and emergency vehicles. According to human rights groups, over two hundred health workers have been killed in nearly two thousand assaults. The underground facility is built from multiple reinforced shelters, with timber beams, soil and sand laid on top reaching the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges released by drone.

A major steel and mining company, which financed the construction, intends to build 20 facilities in total. The head of the nation's security agency and former military leader, Rustem Umerov, said they would be “vitally important for saving the survival of our military and assisting defenders on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had undertaken after the enemy's military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained certain injured soldiers had to endure delays many hours or even days before they could be transported because of the danger of aerial attacks. “We had a pair of severely injured patients who arrived at 3am. I had to perform a double amputation on one of them. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an ambulance. The transport was parked beneath a bush. He and the two other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, walked toward the doorway to greet the incoming patients. “Our facility operates active 24 hours a day,” Holovashchenko stated. “The work is continuous.”