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Sparse trees hide the entryway. One descending wooden tunnel leads down to a brightly lit reception area. There is a surgery unit, equipped with beds, cardiac monitors and ventilators. Plus shelves full of medical equipment, medications and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Hospital staff at an underground hospital look at a screen displaying Russian kamikaze and reconnaissance UAVs in the region.

Welcome to the nation's covert below-ground medical facility. 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 Donetsk oblast. “Our facility sits six meters under the earth. It’s the most secure method of providing help to our wounded soldiers. And it keeps medical personnel safe,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring amputations, or serious stomach wounds. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with lethal precision. “90% of our cases are from first-person view drones. We see few bullet injuries. This is an age of unmanned aircraft and a new type of war,” the doctor said.

Major Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

On one afternoon last week, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone blast had ripped a small hole in his limb. “War is terrible. My comrade beside me, Vasyl, was killed,” he stated. “He collapsed. Then the Russians dropped a second explosive on him.” He added: “All structures in the village is demolished. We see drones everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his unit endured over a month in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their position was on foot. All supplies arrived by quadcopter: rations and water. Seven days following he was injured, he traveled five kilometers (roughly three miles), requiring several 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 nurse provided him with new civilian clothes: a T-shirt and a set of pale denim trousers.

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

A different casualty, 38-year-old a serviceman, said a drone blast had left him with a head injury. “I was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. A relative has been killed. There are continuous explosions.” A construction worker working in Lithuania, he noted he had returned to his homeland and enlisted to fight days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a bloody bandage and treated his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar struck 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 military group. Someone must defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently targeted hospitals, health facilities, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been killed in almost two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, earth and sand placed above up to ground level. It can withstand impacts from large-caliber artillery shells and even multiple 8kg explosive devices released by aerial means.

A major steel and mining company, which funded the building, plans to build 20 units in total. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, declared they would be “vitally essential for saving the survival of our armed forces and supporting troops on the frontline.” The company referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

One of the facility's surgical rooms.

Holovashchenko, explained some wounded personnel had to wait many hours or even multiple days before they could be transported because of the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at the early hours. I had to carry out a removal of both limbs on one of them. His bleeding control device had been on for such an extended period there was no alternative.” How did he cope with severe surgeries? “My career in medicine for two decades. One must concentrate,” he said.

Medical assistants wheeled the soldier up the passage and into an emergency vehicle. The vehicle was parked under a bush. He and the two other military members were taken to the city of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked up to the entrance to await the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”