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Sparse foliage conceal the entryway. A sloping wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of medical equipment, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a screen. The screen reveals the flight patterns of enemy spy drones as they zigzag in the sky above.

Hospital staff at an subterranean medical center look at a screen showing enemy suicide and reconnaissance drones in the area.

Welcome to the nation'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 combat zone and the city of a key location in Donetsk oblast. “Our facility sits six meters below the ground. This is the safest method of providing help to our wounded military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Others can walk. The vast majority are the victims of enemy FPV aerial devices, which drop explosives with deadly accuracy. “90% of our patients are from FPVs. We see few gunshot wounds. This is an age of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured troops in eastern Ukraine.

On one day recently, a group of three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Our side's and the enemy's.”

The soldier explained his unit spent 43 days in a forest area close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. Necessary provisions arrived by drone: food and water. Seven days after he was hurt, he traveled 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored denim trousers.

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

Another patient, 38-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he said. “I think I was fortunate to remain alive. My cousin has been lost. We face ongoing detonations.” A builder employed in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as doctors laid him on a bed, removed a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of artillery hit me. It was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my unit. Someone must defend our nation,” he said.

Medical staff care for the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Since 2022, enemy forces has consistently attacked hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, over two hundred health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple reinforced shelters, with timber beams, earth and sand laid on top reaching the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram explosive devices released by drone.

The Ukrainian steel and mining company, which funded the building, intends to erect twenty facilities in total. A senior official of the nation's security agency and former military leader, the official, declared they would be “critically essential for preserving the survival of our armed forces and assisting defenders on the battlefront.” The organization referred to the initiative as the “largest-scale and challenging” it had implemented after the enemy's invasion.

An example of the facility's surgical rooms.

Holovashchenko, explained some wounded personnel had to endure delays hours or even days before they could be evacuated due to the danger of air assaults. “We had a pair of critically ill casualties who came at 3am. It was necessary to carry out a double amputation on a patient. The soldier's bleeding control device had been on for so long there was no other option.” How did he cope with severe operations? “My career in healthcare for two decades. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier up the passage and into an emergency vehicle. The transport was stationed beneath a bush. He and the other soldiers were transferred to the city of a major city for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, Vasilevs, walked up to the entrance to await the next arrivals. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”