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Sparse trees conceal the entryway. One sloping timber passageway descends to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. And cabinets stocked of medical equipment, medications and organized stacks of spare clothes. Within a break area with a washing machine and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground medical center look at a monitor showing Russian suicide and surveillance UAVs in the area.

Welcome to Ukraine’s secret underground medical facility. This center began operations in the eighth month and is the second such installation, situated in the eastern part of the country not far from the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres under the ground. This is the most secure way of delivering care to our injured soldiers. It also ensures healthcare workers protected,” stated the facility's lead doctor, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of enemy FPV aerial devices, which drop grenades with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. It’s an era of unmanned aircraft and a different kind of war,” the surgeon said.

Maj the senior surgeon at the underground facility for caring for wounded soldiers in the eastern region.

On one afternoon recently, a group of three military members limped into the hospital. The least severely hurt, 28-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “War is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the enemy forces released a second grenade on him.” He added: “All structures in the village is demolished. We see drones everywhere and casualties. Ours and the enemy's.”

Dvorskyi explained his unit spent 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to get to their position was by walking. All supplies arrived by quadcopter: food and water. Seven days following he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to a point where an military transport was able to pick him up. At the clinic, a medic assessed his physical condition. Following care, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, 28, said a FPV drone caused a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “I was in a trench shelter. Suddenly it became black. I lost sensation anything or any sound,” he said. “I believe I was fortunate to remain alive. A relative has been killed. We face continuous explosions.” A builder employed in Lithuania, he said he had returned to his homeland and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a medical cot, took off a bloody bandage and treated his two-day-old injury from fragments. Covered in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my military group. Our forces has to protect our nation,” he said.

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

Since 2022, Russia has consistently targeted hospitals, clinics, maternity wards and emergency vehicles. According to human rights groups, over two hundred health workers have been fatally attacked in nearly two thousand attacks. This subterranean hospital is built from multiple steel bunkers, with wooden supports, soil and sand placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even multiple eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which financed the construction, plans to erect twenty facilities in total. The head of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “critically important for preserving the lives of our armed forces and assisting defenders on the battlefront.” The company described the project as the “largest-scale and demanding” it had undertaken after Russia’s military offensive.

One of the facility's surgical rooms.

The surgeon, explained some wounded personnel had to endure delays many hours or even days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill patients who came at 3am. It was necessary to perform a removal of both limbs on a patient. The soldier's tourniquet had been applied for so long there was no alternative.” How did he cope with severe surgeries? “My career in healthcare for 20 years. One must focus,” he said.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The transport was parked beneath a shrub. He and the other soldiers were taken to the city of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, Vasilevs, padded up to the entrance to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”