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Scrubby trees conceal the entryway. One sloping wooden passageway descends to a brightly lit welcome zone. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus shelves stocked of healthcare supplies, medications and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, physicians monitor a display. It shows the movements of enemy surveillance UAVs as they zigzag in the sky above.

Hospital personnel at an subterranean medical center look at a screen showing Russian suicide and reconnaissance UAVs in the area.

Welcome to the nation's covert below-ground medical facility. The facility began operations in August and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres under the earth. This is the safest way of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which drop grenades with deadly accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj the senior surgeon at the underground facility for treating injured troops in the eastern region.

During one day last week, three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “War is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the Russians dropped a second grenade on him.” He continued: “Everything in the village is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

The soldier said his unit spent 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their position was on foot. Necessary provisions came by drone: rations and water. A week following he was hurt, he walked 5km (roughly three miles), requiring three hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, said a FPV drone caused a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or hear anything,” he explained. “I think I was lucky to survive. My cousin has been killed. There are continuous detonations.” A construction worker working in a neighboring country, he said he had returned to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a bed, took off a bloody bandage and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of artillery hit me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To recover. This may require a several months. After that, to return to my unit. Our forces must protect our nation,” he affirmed.

Medical staff treat the wounded soldier, who was hit in the dorsal area by a fragment of artillery shell.

Since 2022, enemy forces has consistently targeted hospitals, health facilities, maternity wards and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist direct hits from large-caliber projectiles and even three eight-kilogram TNT charges dropped by aerial means.

A major steel and mining company, which financed the construction, plans to build twenty facilities in all. The head of the nation's national security council and ex- military leader, Rustem Umerov, declared they would be “critically important for preserving the lives of our military and supporting troops on the frontline.” The company described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

One of the facility's surgical rooms.

Holovashchenko, explained certain wounded personnel had to endure delays hours or even days before they could be evacuated because of the threat of aerial attacks. “We had two critically ill casualties who came at 3am. It was necessary to perform a double amputation on one of them. His tourniquet had been on for so long there was no alternative.” How did he cope with severe operations? “My career in medicine for 20 years. You have to focus,” he remarked.

Medical assistants transported the soldier up the tunnel and into an ambulance. The transport was stationed under a shrub. He and the other soldiers were taken to the city of a major city for further treatment. The underground hospital staff took a break. The facility's ginger cat, the mascot, padded toward the doorway to await the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”