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Sparse foliage hide the entrance. A sloping timber tunnel descends to a well-illuminated welcome zone. Inside lies a surgery unit, equipped with beds, heart rate sensors and ventilators. Plus cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, physicians keep an eye on a screen. It shows the flight patterns of enemy spy drones as they zigzag in the air above.

Medical staff at an subterranean medical center observe a screen showing Russian suicide and reconnaissance drones in the region.

Welcome to Ukraine’s covert underground hospital. The facility opened in the eighth month and is the second of its kind, situated in eastern Ukraine close to the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. This is the safest way of delivering care to our injured soldiers. It also ensures healthcare workers safe,” stated the facility's surgeon, Maj the chief surgeon.

This medical station handles thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the victims of enemy FPV drones, which drop explosives with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a new type of war,” the doctor said.

Major Oleksandr Holovashchenko at the underground facility for treating wounded troops in the eastern region.

On one afternoon last week, three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “Conflict is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He fell down. Subsequently the Russians released a second explosive on him.” He continued: “Everything in the settlement is demolished. We see drones everywhere and casualties. Ours and the enemy's.”

Dvorskyi said his unit endured 43 days in a forest area close to the city, which enemy forces has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies came by drone: rations and water. A week after he was hurt, he traveled 5km (roughly three miles), taking several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, stated a FPV aerial device caused a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it went dark. 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 construction worker working in a neighboring country, he said he had come back to his homeland and enlisted to fight days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as medical staff laid him on a bed, took off a bloody dressing and treated his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his sister. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. That will take a few months. Subsequently, to return to my military group. Our forces has to protect our country,” he affirmed.

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

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been fatally attacked in nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and sand laid on top reaching ground level. It can withstand direct hits from 152mm artillery shells and even multiple 8kg explosive devices released by aerial means.

A major industrial group, which funded the construction, intends to build 20 units in total. A senior official of Ukraine’s security agency and ex- military leader, Rustem Umerov, declared they would be “critically important for preserving the survival of our military and assisting defenders on the frontline.” The organization described the initiative as the “most ambitious and demanding” it had undertaken since Russia’s invasion.

An example of the facility's operating theatres.

The surgeon, explained some injured personnel had to endure delays many hours or even days before they could be evacuated due to the threat of aerial attacks. “We had a pair of critically ill patients who arrived at 3am. It was necessary to carry out a double amputation on a patient. His tourniquet had been on for so long there was no alternative.” How did he cope with severe operations? “My career in healthcare for 20 years. One must focus,” he said.

Medical assistants transported Mykolaichuk through the tunnel and into an emergency vehicle. The transport was parked under a shrub. The patient and the other military members were taken to the urban center of a major city for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, Vasilevs, walked up to the entrance to await the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”