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Scrubby foliage hide the entrance. One descending timber passageway descends to a well-illuminated reception area. There is a operating ward, equipped with gurneys, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, medications and neat piles of extra garments. Within a staff room with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Medical personnel at an underground hospital observe a screen displaying Russian suicide and surveillance UAVs in the region.

This is Ukraine’s covert underground hospital. This center began operations in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the safest method of delivering care to our wounded soldiers. And it keeps healthcare workers safe,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station treats thirty to forty patients a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the victims of Russian FPV aerial devices, which release explosives with lethal precision. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a different kind of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for treating wounded troops in eastern Ukraine.

On one afternoon last week, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an FPV explosion had torn a small hole in his leg. “War is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a another explosive on him.” He continued: “All structures in the settlement is demolished. We see UAVs all around and casualties. Ours and theirs.”

Dvorskyi explained his squad endured over a month in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to get to their position was on foot. Necessary provisions came by quadcopter: rations and water. A week following he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse provided him with new non-military attire: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, stated a FPV drone ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to remain alive. A relative has been killed. We face continuous explosions.” A builder working in Lithuania, Filipchuk noted he had returned to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a medical cot, took off a bloody bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his family member. “A fragment of mortar hit me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. This may require a several months. Subsequently, to return to my military group. Someone has to defend our country,” he said.

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

Over the past years, Russia has repeatedly attacked medical centers, clinics, obstetric units and ambulances. According to international monitors, 261 health workers have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even three eight-kilogram explosive devices released by aerial means.

The Ukrainian industrial group, which financed the construction, intends to erect 20 facilities in all. A senior official of the nation's security agency and former defence minister, the official, declared they would be “critically essential for saving the survival of our armed forces and assisting troops on the battlefront.” The organization described the initiative as the “most ambitious and demanding” it had undertaken after the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, explained some injured soldiers had to wait hours or even days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of 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 such an extended period there was no other option.” How did he cope with severe operations? “I’ve been medicine for two decades. One must focus,” he said.

Orderlies wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. He and the two other soldiers were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s orange feline, Vasilevs, padded up to the doorway to greet the next arrivals. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”