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Sparse foliage conceal the entryway. A sloping wooden passageway leads down to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, heart rate sensors and ventilators. And cabinets stocked of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the movements of enemy spy drones as they zigzag in the sky above.

Hospital staff at an underground hospital look at a monitor displaying enemy kamikaze and reconnaissance UAVs in the region.

Welcome to the nation's covert below-ground hospital. This center opened in August and is the second of its kind, located in eastern Ukraine close to the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the most secure way of providing help to our injured military personnel. It also ensures healthcare workers safe,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which release grenades with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Major the senior surgeon at the subterranean facility for treating wounded troops in the eastern region.

On one day last week, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his leg. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians released a second explosive on him.” He continued: “All structures in the village is demolished. We see drones all around and casualties. Our side's and theirs.”

The soldier said his unit spent over a month in a forest area near the city, which Russia has been attempting to capture since last year. Sole access to reach their location was on foot. Necessary provisions came by quadcopter: food and water. A week after he was injured, he traveled five kilometers (roughly three miles), taking several hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his physical condition. After treatment, a nurse gave him fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a first-person view aerial device caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or any sound,” he said. “I think I was lucky to remain alive. A relative has been killed. We face continuous explosions.” A construction worker working in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a bed, took off a bloody dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of artillery hit me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. This may require a few months. After that, to return to my unit. Someone has to protect our nation,” he affirmed.

Doctors treat the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has repeatedly attacked medical centers, health facilities, obstetric units and emergency vehicles. According to human rights groups, 261 medical personnel have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is built from multiple steel bunkers, with wooden supports, earth and sand laid on top up to ground level. It is designed to resist direct hits from large-caliber artillery shells and even three 8kg explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, plans to erect 20 units in all. The head of Ukraine’s security agency and former defence minister, Rustem Umerov, declared they would be “critically essential for preserving the survival of our military and supporting defenders on the frontline.” The company referred to the project as the “most ambitious and challenging” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, explained certain wounded soldiers had to endure delays hours or even days before they could be evacuated due to the danger of air assaults. “Our facility received a pair of critically ill casualties who came at the early hours. It was necessary to carry out a double amputation on one of them. His bleeding control device had been on for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for two decades. You have to concentrate,” he said.

Orderlies wheeled Mykolaichuk through the passage and into an ambulance. The vehicle was stationed beneath a shrub. He and the other military members were transferred to the urban center of Dnipro for additional medical care. The underground medical team took a break. The hospital’s ginger cat, the mascot, walked up to the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”