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Scrubby foliage hide the entryway. A sloping wooden passageway descends to a well-illuminated reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And cabinets full of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital personnel at an subterranean hospital observe a screen showing enemy kamikaze and surveillance drones in the region.

Welcome to the nation's covert below-ground hospital. The facility opened in the eighth month and is the second such installation, situated in eastern Ukraine close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. It’s the safest method of providing help to our injured military personnel. And it keeps healthcare workers safe,” stated the facility's lead doctor, Maj the chief surgeon.

This medical station treats 30-40 patients a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or serious stomach wounds. Others can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with lethal precision. “90% of our cases are from FPVs. We see few bullet injuries. It’s an era of unmanned aircraft and a new type of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for injured soldiers in eastern Ukraine.

During one afternoon recently, three soldiers walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his limb. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He continued: “All structures in the village is destroyed. We see UAVs everywhere and bodies. Our side's and the enemy's.”

Dvorskyi explained his unit endured over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to reach their location was by walking. Necessary provisions arrived by quadcopter: rations and water. A week after he was injured, he walked 5km (about 3 miles), taking several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant provided him with new non-military attire: a T-shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, said a FPV aerial device ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been killed. We face continuous detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had returned to Ukraine and enlisted to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, removed a stained bandage and cleaned his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his sister. “A piece of artillery hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Our forces must defend our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the back by a fragment of artillery shell.

Over the past years, Russia has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. Per human rights groups, over two hundred health workers have been fatally attacked in almost two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and sand placed above reaching the surface. It is designed to resist direct hits from large-caliber artillery shells and even multiple eight-kilogram explosive devices dropped by aerial means.

A major industrial group, which funded the construction, plans to erect 20 facilities in total. The head of Ukraine’s security agency and former military leader, the official, said they would be “critically essential for preserving the survival of our armed forces and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

One of the centre’s surgical rooms.

The surgeon, said some wounded personnel had to wait hours or even days before they could be transported due to the threat of aerial attacks. “We had a pair of severely injured casualties who arrived at 3am. I had to perform a double amputation on a patient. His tourniquet had been on for such an extended period there was no other option.” What is his method with severe surgeries? “My career in medicine for two decades. You have to concentrate,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was parked beneath a shrub. The patient and the other military members were transferred to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The facility's orange feline, the mascot, walked up to the entrance to greet the next arrivals. “We are open around the clock,” the surgeon stated. “The work is continuous.”