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Scrubby trees hide the entryway. One descending wooden tunnel descends to a brightly lit welcome zone. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an subterranean hospital observe a screen showing enemy kamikaze and reconnaissance UAVs in the area.

Welcome to Ukraine’s covert underground medical facility. The facility began operations in the eighth month and is the second of its kind, located in the eastern part of the country not far from the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres below the ground. It’s the most secure method of providing help to our injured military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Their conditions vary. Some have catastrophic leg injuries necessitating surgical removal, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop grenades with lethal precision. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. This is an age of unmanned aircraft and a new type of conflict,” the doctor explained.

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

During one afternoon recently, a group of three military members walked with difficulty into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his limb. “War is horrific. My comrade beside me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the Russians dropped a another grenade on him.” He continued: “All structures in the settlement is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

Dvorskyi explained his unit endured over a month in a forest area close to the city, which enemy forces has been trying to seize since last year. Sole access to get to their position was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week after he was injured, he traveled five kilometers (about 3 miles), taking several hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. Following care, a nurse gave him fresh non-military attire: a T-shirt and a set of pale denim trousers.

The soldier, 28, said a FPV drone ripped a small hole in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to remain alive. A relative has been lost. There are continuous explosions.” A construction worker working in a neighboring country, Filipchuk said he had returned to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as doctors placed him on a medical cot, removed a bloody dressing and cleaned his recent shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his sister. “A piece of artillery hit me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a few months. After that, to return to my unit. Someone has to defend our nation,” he affirmed.

Doctors treat the wounded soldier, who was injured in the back by a fragment of mortar.

Over the past years, Russia has consistently targeted medical centers, health facilities, maternity wards and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in almost two thousand assaults. The underground facility is constructed from four reinforced shelters, with wooden supports, soil and sand placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 facilities in total. The head of Ukraine’s national security council and former defence minister, the official, declared they would be “critically essential for preserving the lives of our military and assisting defenders on the battlefront.” The organization referred to the initiative as the “largest-scale and demanding” it had undertaken since the enemy's military offensive.

An example of the facility's surgical rooms.

Holovashchenko, explained certain injured soldiers had to endure delays hours or even days before they could be evacuated because of the danger of aerial attacks. “Our facility received a pair of critically ill patients who arrived at 3am. It was necessary 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.” What is his method with traumatic operations? “My career in healthcare for 20 years. One must focus,” he said.

Orderlies wheeled Mykolaichuk through the passage and into an emergency vehicle. The transport was stationed under a shrub. The patient and the two other military members were taken to the urban center of a major city for additional medical care. The subterranean medical team took a break. The hospital’s ginger cat, the mascot, walked toward the entrance to greet the next arrivals. “We are open around the clock,” Holovashchenko stated. “It doesn’t stop.”