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Sparse trees hide the entryway. A sloping timber passageway leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, medications and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, doctors monitor a screen. It shows the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital look at a screen displaying enemy suicide and surveillance UAVs in the region.

Welcome to Ukraine’s covert below-ground hospital. The facility opened in August and is the second of its kind, situated 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 providing help to our injured military personnel. And it keeps medical personnel protected,” stated the facility's surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 patients a each day. Cases differ widely. Some have devastating limb trauma requiring surgical removal, or severe stomach wounds. Others can walk. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “90% of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean installation for treating wounded soldiers in the eastern region.

On one afternoon last week, three military members limped into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone explosion had ripped a minor wound in his leg. “War is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a another grenade on him.” He added: “Everything in the village is destroyed. We see UAVs everywhere and bodies. Our side's and theirs.”

The soldier said his squad spent over a month in a forest area near Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to reach their location was on foot. Necessary provisions arrived by drone: food and water. Seven days following he was injured, he walked 5km (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a nurse provided him with fresh civilian clothes: a T-shirt and a set of light-colored denim trousers.

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

Another patient, thirty-eight-year-old a serviceman, said a drone blast had left him with a head injury. “I was in a trench shelter. It suddenly became black. I couldn’t feel anything or any sound,” he said. “I think I was lucky to survive. A relative has been killed. We face ongoing detonations.” A builder employed in a neighboring country, he said he had come back to Ukraine and enlisted to fight days before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as medical staff placed him on a medical cot, took off a bloody dressing and treated his recent injury from fragments. Covered in a thermal sheet, he used a mobile phone to call his sister. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my unit. Someone has to protect our nation,” he said.

Doctors care for Taras Mykolaichuk, who was injured in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in almost 2,000 attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, soil and granular material laid on top reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even multiple 8kg explosive devices released by aerial means.

The Ukrainian steel and mining company, which financed the construction, plans to erect 20 units in all. The head of Ukraine’s security agency and former military leader, Rustem Umerov, said they would be “critically essential for preserving the survival of our military and assisting troops on the battlefront.” The company described the initiative as the “largest-scale and demanding” it had implemented after the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, said some injured soldiers had to endure delays hours or even multiple days before they could be transported because of the threat of aerial attacks. “We had two critically ill casualties who came at the early hours. It was necessary to carry out a double amputation on one of them. His tourniquet had been on for so long there was no alternative.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. One must focus,” he said.

Orderlies transported the soldier up the passage and into an ambulance. The transport was parked under a bush. The patient and the other soldiers were taken to the city of a major city for further treatment. The subterranean hospital staff took a break. The hospital’s ginger cat, the mascot, padded up to the entrance to greet the incoming patients. “We are active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”