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Sparse foliage hide the entryway. A sloping timber tunnel leads down to a brightly lit reception area. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, 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 flight patterns of Russian surveillance UAVs as they weave in the sky above.

Medical personnel at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance UAVs in the area.

Welcome to Ukraine’s secret underground hospital. The facility opened in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres below the ground. This is the safest method of delivering care to our injured military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty patients a day. Cases differ widely. Certain individuals suffer from devastating limb trauma requiring amputations, or serious stomach wounds. Some patients can walk. Almost all are the victims of enemy first-person view (FPV) aerial devices, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter few gunshot wounds. This is an age of drones and a new type of war,” the surgeon explained.

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

On one afternoon recently, three military members limped into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his leg. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he stated. “He fell down. Subsequently the Russians dropped a second explosive on him.” He continued: “Everything in the settlement is destroyed. There are UAVs everywhere and casualties. Our side's and theirs.”

Dvorskyi said his unit spent over a month in a wooded zone near the city, which Russia has been trying to seize since last year. Sole access to reach their location was by walking. Necessary provisions arrived by quadcopter: food and water. Seven days after he was hurt, he walked 5km (roughly three miles), taking three hours, to a point where an military transport was able to pick him up. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse gave him new non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a first-person view aerial device caused a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to survive. My cousin has been killed. We face continuous explosions.” A construction worker employed in Lithuania, he noted he had returned to his homeland and enlisted to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a medical cot, took off a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of artillery hit me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a several months. After that, to return to my unit. Someone must defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the back by a piece of mortar.

Over the past years, Russia has consistently targeted hospitals, clinics, obstetric units and emergency vehicles. 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 four steel bunkers, with wooden supports, earth and granular material placed above up to ground level. It can withstand impacts from large-caliber projectiles and even multiple 8kg explosive devices dropped by drone.

A major industrial group, which financed the building, intends to build 20 units in total. The head of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “critically important for saving the survival of our armed forces and supporting troops on the battlefront.” The organization referred to the project as the “largest-scale and demanding” it had implemented after Russia’s invasion.

An example of the centre’s operating theatres.

The surgeon, explained some injured personnel had to wait hours or even multiple days before they could be transported due to the threat of air assaults. “We had a pair of critically ill patients who came at 3am. I had to perform a removal of both limbs on one of them. His tourniquet had been applied for so long there was no alternative.” What is his method with severe surgeries? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Medical assistants wheeled Mykolaichuk up the passage and into an ambulance. The transport was stationed under a bush. The patient and the other soldiers were transferred to the city of a major city for additional medical care. The subterranean hospital staff paused for rest. The facility's ginger cat, Vasilevs, walked toward the doorway to greet the incoming patients. “Our facility operates open around the clock,” the surgeon said. “The work is continuous.”