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Sparse trees hide the entrance. One descending timber passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, cardiac monitors and ventilators. And shelves full of medical equipment, medications and neat piles of spare clothes. In a break area with a laundry appliance and kettle, physicians keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance UAVs in the region.

Welcome to Ukraine’s covert below-ground hospital. The facility began operations in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres below the earth. This is the most secure method of delivering care to our wounded military personnel. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point treats 30-40 patients a day. Their conditions vary. Some have catastrophic leg injuries requiring amputations, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with deadly accuracy. “90% of our cases are from FPVs. We encounter few bullet injuries. This is an age of unmanned aircraft and a different kind of war,” the surgeon explained.

Maj the senior surgeon at the underground facility for treating wounded troops in the eastern region.

On one afternoon last week, three soldiers limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his limb. “War is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a another explosive on him.” He continued: “All structures in the village is destroyed. There are UAVs everywhere and bodies. Our side's and theirs.”

The soldier said his squad endured over a month in a forest area close to the city, which Russia has been trying to seize since last year. The only way to reach their location was by walking. Necessary provisions came by drone: rations and water. Seven days after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his physical condition. Following care, a medical attendant gave him fresh civilian clothes: a shirt and a pair of pale denim trousers.

The soldier, 28, stated a FPV aerial device caused a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast 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 fortunate to remain alive. My cousin has been killed. We face ongoing explosions.” A builder working in Lithuania, he noted he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a bed, removed a bloody dressing and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to call his family member. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. That will take a few months. After that, to return to my unit. Someone must protect our country,” he said.

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

Over the past years, Russia has repeatedly attacked medical centers, clinics, maternity wards and ambulances. Per international monitors, over two hundred health workers have been fatally attacked in almost 2,000 assaults. This subterranean hospital is built from multiple steel bunkers, with timber beams, earth and granular material placed above reaching ground level. It is designed to resist direct hits from 152mm artillery shells and even three eight-kilogram explosive devices dropped by drone.

A major industrial group, which financed the building, intends to build 20 facilities in total. A senior official of Ukraine’s security agency and ex- military leader, the official, said they would be “critically essential for saving the lives of our armed forces and assisting troops on the battlefront.” The organization referred to the project as the “most ambitious and demanding” it had undertaken 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 due to the threat of aerial attacks. “Our facility received two severely injured casualties who arrived at the early hours. I had to perform a double amputation on one of them. His tourniquet had been applied for so long there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for two decades. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an ambulance. The vehicle was parked under a shrub. The patient and the other soldiers were taken to the urban center of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, the mascot, walked up to the doorway to await the incoming patients. “Our facility operates open around the clock,” the surgeon said. “It doesn’t stop.”