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Sparse foliage hide the entryway. A sloping timber tunnel leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, drugs and organized stacks of extra garments. In a break area with a washing machine and kettle, doctors keep an eye on a screen. It shows the flight patterns of enemy spy drones as they weave in the sky above.

Medical staff at an subterranean medical center look at a screen displaying enemy suicide and surveillance drones in the region.

This is Ukraine’s secret underground medical facility. This center began operations in the eighth month and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of a key location in the Donetsk region. “We are 6 metres below the ground. This is the most secure method of delivering care to our injured military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian FPV drones, which drop explosives with deadly precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. This is an age of unmanned aircraft and a different kind of war,” the surgeon said.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded troops in eastern Ukraine.

On one afternoon recently, a group of three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, reported an FPV blast had ripped a small hole in his leg. “War is terrible. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and bodies. Ours and the enemy's.”

The soldier said his unit endured 43 days in a wooded zone near the city, which Russia has been trying to seize for many months. Sole access to reach their location was on foot. Necessary provisions came by drone: food and drinking water. Seven days after he was hurt, he walked 5km (about 3 miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant gave him fresh civilian clothes: a shirt and a set of pale jeans.

The soldier, 28, said a first-person view drone ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a dugout. It suddenly went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was fortunate to survive. A relative has been lost. There are continuous explosions.” A construction worker working in Lithuania, Filipchuk said he had come back to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors placed him on a bed, took off a stained dressing and treated his two-day-old injury from fragments. Covered in a foil blanket, he used a cellphone to call his family member. “A piece of artillery struck me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. After that, to go back to my military group. Our forces must defend our country,” he affirmed.

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

Since 2022, Russia has consistently attacked hospitals, clinics, maternity wards and ambulances. According to human rights groups, over two hundred health workers have been fatally attacked in almost two thousand assaults. The underground facility is constructed from four reinforced shelters, with timber beams, earth and granular material placed above up to ground level. It is designed to resist direct hits from large-caliber projectiles and even three eight-kilogram explosive devices released by aerial means.

The Ukrainian steel and mining company, which funded the building, plans to build 20 units in total. The head of the nation's national security council and former defence minister, Rustem Umerov, declared they would be “critically important for preserving the lives of our military and assisting troops on the frontline.” The company described the project as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

One of the facility's surgical rooms.

Holovashchenko, explained some wounded soldiers had to wait many hours or even days before they could be evacuated due to the danger of aerial attacks. “We had a pair of critically ill patients who came at the early hours. It was necessary to perform a double amputation on one of them. The soldier's tourniquet had been on for such an extended period there was no other option.” How did he cope with severe operations? “My career in healthcare for 20 years. You have to concentrate,” he said.

Orderlies transported the soldier up the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the other military members were taken to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded toward the doorway to greet the incoming patients. “We are active 24 hours a day,” Holovashchenko stated. “The work is continuous.”