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Sparse foliage hide the entrance. One sloping wooden passageway leads down to a brightly lit welcome zone. There is a operating ward, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets full of medical equipment, medications and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Medical staff at an underground hospital look at a monitor displaying Russian suicide and reconnaissance UAVs in the area.

This is Ukraine’s secret below-ground hospital. This center opened in August and is the second such installation, 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 6 metres below the earth. It’s the safest way of delivering care to our injured soldiers. It also ensures medical personnel protected,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Cases differ widely. Some have catastrophic leg injuries necessitating surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of enemy FPV drones, which drop grenades with lethal precision. “90% of our patients are from first-person view drones. We see few bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for injured troops in the eastern region.

During one afternoon recently, three military members limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his limb. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces dropped a second grenade on him.” He added: “Everything in the village is destroyed. There are drones everywhere and casualties. Our side's and the enemy's.”

The soldier explained his squad endured 43 days in a forest area near the city, which Russia has been attempting to capture since last year. Sole access to get to their position was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week following he was hurt, he traveled 5km (about 3 miles), taking several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant gave him fresh civilian clothes: a T-shirt and a pair of pale jeans.

The soldier, 28, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, said a UAV explosion had left him with a head injury. “My position was in a trench shelter. Suddenly it became black. I lost sensation anything or any sound,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. There are ongoing explosions.” A construction worker employed in Lithuania, he said he had come back to his homeland and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff laid him on a medical cot, removed a bloody bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to call his family member. “A fragment of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a few months. Subsequently, to go back to my unit. Someone must protect our nation,” he said.

Medical staff treat the wounded soldier, who was hit in the back by a piece of mortar.

Since 2022, enemy forces has consistently attacked hospitals, health facilities, maternity wards and ambulances. According to human rights groups, 261 health workers have been killed in almost 2,000 attacks. The underground facility is built from four steel bunkers, with wooden supports, earth and granular material laid on top reaching ground level. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges released by drone.

A major industrial group, which funded the building, plans to build twenty facilities in total. The head of Ukraine’s security agency and former military leader, the official, said they would be “critically important for saving the survival of our armed forces and assisting troops on the frontline.” The company described the initiative as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

One of the facility's surgical rooms.

The surgeon, explained some wounded soldiers had to endure delays many hours or even multiple days before they could be transported because of the danger of air assaults. “We had a pair of critically ill patients who came at the early hours. I had to perform a double amputation on a patient. The soldier's bleeding control device had been on for such an extended period there was no alternative.” What is his method with traumatic operations? “My career in healthcare for 20 years. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier up the tunnel and into an emergency vehicle. The transport was parked under a bush. The patient and the other military members were transferred to the city of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded toward the entrance to await the incoming patients. “We are active 24 hours a day,” Holovashchenko stated. “The work is continuous.”