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Scrubby foliage hide the entryway. A sloping timber tunnel leads down to a brightly lit welcome zone. There is a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets full of medical equipment, medications and organized stacks of extra garments. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. It shows the movements of Russian spy drones as they weave in the sky above.

Hospital staff at an subterranean medical center look at a monitor displaying Russian suicide and reconnaissance drones in the region.

This is Ukraine’s secret below-ground hospital. The facility began operations in August and is the second of its kind, located in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. This is the safest method of providing help to our wounded soldiers. And it keeps medical personnel safe,” stated the facility's surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or severe abdominal injuries. Some patients can walk. The vast majority are the victims of enemy FPV aerial devices, which drop explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see few bullet injuries. This is an era of drones and a different kind of conflict,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded soldiers in the eastern region.

On one day last week, three military members limped into the facility. The most lightly injured, 28-year-old one soldier, reported an first-person view drone explosion had ripped a minor wound in his leg. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he stated. “He fell down. Subsequently the Russians dropped a second grenade on him.” He continued: “All structures in the village is destroyed. We see UAVs everywhere and casualties. Ours and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone near the city, which Russia has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions arrived by drone: rations and drinking water. Seven days following he was injured, he traveled five kilometers (roughly three miles), requiring three hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff checked his vital signs. After treatment, a nurse provided him with new civilian clothes: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, said a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he explained. “I think I was lucky to survive. A relative has been lost. There are ongoing detonations.” A builder working in Lithuania, Filipchuk noted he had come back to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as doctors laid him on a medical cot, took off a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of mortar hit me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my unit. Someone has to protect our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the dorsal area by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and granular material placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even three eight-kilogram TNT charges released by aerial means.

A major industrial group, which financed the construction, intends to erect 20 facilities in total. The head of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “critically important for saving the lives of our military and assisting defenders on the battlefront.” The organization described the initiative as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said certain wounded soldiers had to endure delays hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received a pair of severely injured casualties who came at 3am. I had to perform a removal of both limbs on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with severe operations? “My career in healthcare for two decades. One must focus,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The transport was parked under a shrub. The patient and the two other military members were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, the mascot, padded toward the entrance to await the incoming patients. “We are active around the clock,” the surgeon said. “It doesn’t stop.”