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Scrubby trees conceal the entryway. A descending wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and ventilators. And cabinets full of medical equipment, drugs and neat piles of spare clothes. In a break area with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the movements of enemy spy drones as they weave in the air above.

Hospital personnel at an subterranean medical center observe a monitor displaying Russian suicide and reconnaissance drones in the area.

This is Ukraine’s secret underground medical facility. This center opened in the eighth month and is the second such installation, located in eastern Ukraine close to the combat zone and the urban area of a key location in Donetsk oblast. “We are 6 metres under the ground. It’s the most secure way of providing help to our injured military personnel. It also ensures medical personnel protected,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring amputations, or serious stomach wounds. Others can move on their own. The vast majority are the victims of Russian FPV aerial devices, which drop grenades with lethal precision. “90% of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the surgeon explained.

Major the senior surgeon at the subterranean facility for treating injured troops in eastern Ukraine.

On one day recently, three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV explosion had torn a small hole in his limb. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a second grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs all around and bodies. Our side's and the enemy's.”

The soldier explained his squad spent 43 days in a forest area near the city, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies came by drone: food and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), taking several hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with new non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, stated a FPV aerial device ripped a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “My position was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been lost. There are continuous detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had returned to Ukraine and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a medical cot, removed a stained bandage and cleaned his two-day-old shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A piece of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. This may require a several months. After that, to go back to my unit. Someone has to defend our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has repeatedly attacked hospitals, health facilities, maternity wards and emergency vehicles. Per international monitors, over two hundred health workers have been killed in almost 2,000 attacks. The underground facility is constructed from four steel bunkers, with wooden supports, earth and sand placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, intends to erect 20 units in total. A senior official of the nation's security agency and former defence minister, the official, said they would be “vitally essential for saving the survival of our armed forces and assisting troops on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, said certain injured personnel had to wait hours or even multiple days before they could be transported due to the danger of aerial attacks. “We had a pair of critically ill casualties who came at 3am. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with severe surgeries? “My career in medicine for two decades. You have to focus,” he remarked.

Medical assistants transported Mykolaichuk through the passage and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other soldiers were transferred to the urban center of a major city for additional medical care. The subterranean medical team paused for rest. The facility's orange feline, Vasilevs, walked toward the entrance to await the incoming patients. “We are active around the clock,” Holovashchenko said. “The work is continuous.”