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Sparse trees conceal the entryway. One sloping wooden passageway leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. Plus cabinets stocked of medical equipment, medications and organized stacks of extra garments. Within a break area with a washing machine and kettle, physicians monitor a screen. It shows the flight patterns of Russian spy drones 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 region.

This is the nation's covert underground medical facility. The facility began operations in the eighth month and is the second of its kind, situated in the eastern part of the country close to the combat zone and the city of a key location in the Donetsk region. “We are 6 metres below the ground. This is the safest way of delivering care to our injured soldiers. And it keeps medical personnel protected,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring amputations, or serious abdominal injuries. Others can walk. Almost all are the victims of enemy first-person view (FPV) drones, which drop explosives with lethal precision. “90% of our cases are from FPVs. We see minimal bullet injuries. It’s an age of drones and a new type of war,” the doctor said.

Maj the senior surgeon at the subterranean facility for caring for wounded soldiers in eastern Ukraine.

During one day recently, a group of three soldiers limped into the facility. The least severely hurt, 28-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his limb. “War is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the enemy forces released a second explosive on him.” He added: “Everything in the settlement is destroyed. There are drones everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a forest area close to the city, which enemy forces has been trying to seize since last year. The only way to reach their location was on foot. Necessary provisions arrived by quadcopter: rations and drinking water. A week following he was injured, he traveled five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his physical condition. Following care, a nurse provided him with fresh civilian clothes: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, said a FPV drone caused a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I think I was fortunate to survive. A relative has been lost. There are ongoing detonations.” A builder employed in a neighboring country, he noted he had returned to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He groaned as doctors laid him on a medical cot, took off a bloody dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his sister. “A piece of mortar hit 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 few months. After that, to return to my unit. Our forces has to protect our nation,” he said.

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

Since 2022, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, over two hundred medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material laid on top reaching the surface. It can withstand direct hits from 152mm projectiles and even three 8kg explosive devices released by drone.

A major industrial group, which funded the building, plans to erect twenty facilities in total. A senior official of the nation's national security council and former military leader, the official, said they would be “vitally essential for preserving the lives of our armed forces and supporting troops on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had undertaken since Russia’s military offensive.

An example of the facility's operating theatres.

The surgeon, explained certain wounded personnel had to endure delays hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “We had a pair of severely injured casualties who arrived at 3am. I had to carry out a removal of both limbs on one of them. 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. One must focus,” he remarked.

Medical assistants transported Mykolaichuk up the passage and into an emergency vehicle. The transport was stationed beneath a bush. The patient and the two other soldiers were transferred to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded up to the doorway to await the next arrivals. “We are open 24 hours a day,” the surgeon stated. “The work is continuous.”