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Sparse trees hide the entrance. A sloping wooden passageway descends to a well-illuminated welcome zone. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians monitor a display. It shows the flight patterns of enemy spy drones as they weave in the sky above.

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

Welcome to Ukraine’s secret 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 Pokrovsk in Donetsk oblast. “We are six meters under the earth. It’s the most secure way of providing help to our injured soldiers. It also ensures medical personnel protected,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have devastating leg injuries requiring amputations, or severe abdominal injuries. Some patients can move on their own. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with lethal precision. “90% of our cases are from FPVs. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a new type of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in the eastern region.

On one day last week, a group of three soldiers limped into the facility. The least severely hurt, 28-year-old one soldier, reported an FPV explosion had ripped a small hole in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He fell down. Then the Russians released a another explosive on him.” He continued: “All structures in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his unit spent 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their position was on foot. Necessary provisions arrived by drone: food and drinking water. Seven days after he was hurt, he traveled five kilometers (about 3 miles), taking several hours, to where an military transport was able to pick him up. At the clinic, a medic checked his vital signs. Following care, a medical attendant provided him with new non-military attire: a shirt and a pair of light-colored jeans.

The soldier, twenty-eight, stated a first-person view aerial device caused a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I think I was lucky to remain alive. A relative has been lost. We face ongoing detonations.” A builder working in a neighboring country, he said he had returned to his homeland and enlisted to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He groaned as doctors placed him on a medical cot, took off a stained dressing and cleaned his recent injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to ring his sister. “A piece of mortar hit me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. Subsequently, to go back to my unit. Someone has to protect our country,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand assaults. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and sand placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian steel and mining company, which funded the building, plans to erect twenty facilities in total. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our armed forces and supporting defenders on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had implemented since Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained certain wounded personnel had to wait many hours or even days before they could be transported due to the danger of aerial attacks. “We had a pair of severely injured casualties who arrived at 3am. It was necessary to perform a removal of both limbs on a patient. The soldier's bleeding control device had been on for so long there was no other option.” How did he cope with severe operations? “My career in medicine for two decades. You have to focus,” he said.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The transport was stationed beneath a bush. The patient and the two other military members were transferred to the city of a major city for additional medical care. The underground hospital staff took a break. The hospital’s orange feline, the mascot, walked up to the entrance to await the next arrivals. “Our facility operates open around the clock,” the surgeon said. “It doesn’t stop.”