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Scrubby foliage hide the entrance. A descending timber passageway descends to a brightly lit welcome zone. There is a operating ward, equipped with gurneys, cardiac monitors and breathing machines. Plus shelves full of healthcare supplies, drugs and neat piles of extra garments. In a break area with a laundry appliance and hot water heater, physicians monitor a screen. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Hospital personnel at an underground hospital look at a screen displaying enemy suicide and surveillance drones in the region.

This is the nation's secret underground hospital. The facility began operations in August and is the second such installation, located in the eastern part of the country close to the frontline and the city of a key location in Donetsk oblast. “Our facility sits six meters below the ground. It’s the safest method of delivering care to our wounded military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or serious 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 lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal bullet injuries. This is an era of unmanned aircraft and a new type of war,” the surgeon explained.

Major the senior surgeon at the underground installation for caring for injured troops in the eastern region.

On one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He fell down. Then the enemy forces released a second explosive on him.” He continued: “All structures in the settlement is demolished. There are drones all around and bodies. Our side's and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. Sole access to reach their position was on foot. All supplies arrived by quadcopter: food and water. A week after he was hurt, he walked five kilometers (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast 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 said. “I think I was fortunate to remain alive. A relative has been lost. There are ongoing explosions.” A builder employed in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to fight days before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as doctors placed him on a medical cot, took off a stained bandage and cleaned his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a cellphone to call his family member. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to go back to my military group. Someone has to protect our country,” he affirmed.

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

Over the past years, Russia has repeatedly attacked medical centers, clinics, maternity wards and ambulances. According to human rights groups, over two hundred health workers have been fatally attacked in almost two thousand assaults. The underground facility is built from multiple steel bunkers, with wooden supports, earth and sand laid on top up to the surface. It is designed to resist direct hits from large-caliber artillery shells and even three eight-kilogram explosive devices released by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect twenty units in all. A senior official of Ukraine’s national security council and ex- military leader, the official, declared they would be “critically important for preserving the survival of our armed forces and supporting defenders on the frontline.” The company described the initiative as the “most ambitious and demanding” it had implemented after Russia’s invasion.

An example of the facility's surgical rooms.

Holovashchenko, said some wounded personnel had to endure delays hours or even days before they could be evacuated due to the danger of aerial attacks. “Our facility received two critically ill patients who came at the early hours. I had to carry out a double amputation on a patient. His tourniquet had been on for such an extended period there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Orderlies transported the soldier through the passage and into an emergency vehicle. The vehicle was stationed under a bush. The patient and the two other military members were taken to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, the mascot, walked up to the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko stated. “The work is continuous.”