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Scrubby trees conceal the entrance. One sloping timber passageway descends to a well-illuminated welcome zone. There is a operating ward, outfitted with beds, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, medications and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the air above.

Medical staff at an underground hospital observe a monitor showing enemy suicide and reconnaissance drones in the area.

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 the eastern part of the country close to the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the earth. This is the safest way of delivering care to our wounded soldiers. It also ensures medical personnel protected,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or serious stomach wounds. Others can walk. Almost all are the victims of Russian first-person view (FPV) aerial devices, which drop grenades with deadly precision. “90% of our patients are from FPVs. We see minimal bullet injuries. It’s an age of drones and a different kind of war,” the surgeon explained.

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

During one afternoon recently, a group of three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a minor wound in his limb. “War is terrible. The guy next to me, Vasyl, was killed,” he said. “He collapsed. Then the enemy forces dropped a second grenade on him.” He continued: “All structures in the settlement is demolished. We see UAVs everywhere and bodies. Ours and the enemy's.”

The soldier said his unit spent 43 days in a forest area near the city, which enemy forces has been attempting to capture since last year. The only way to reach their location was by walking. Necessary provisions came by drone: rations and drinking water. Seven days after he was hurt, he walked five kilometers (roughly three miles), taking several hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a minor injury in his leg.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to survive. My cousin has been lost. We face ongoing explosions.” A construction worker working in a neighboring country, he said he had come back to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as medical staff placed him on a bed, took off a bloody dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of artillery hit me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to go back to my military group. Our forces must protect our nation,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the back by a fragment of mortar.

Since 2022, Russia has consistently targeted hospitals, clinics, maternity wards and emergency vehicles. According to international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and sand laid on top reaching ground level. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg explosive devices dropped by aerial means.

A major industrial group, which financed the building, intends to build twenty facilities in total. The head of the nation's security agency and former military leader, the official, declared they would be “vitally essential for preserving the survival of our military and assisting troops on the frontline.” The organization described the project as the “most ambitious and demanding” it had implemented since the enemy's military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained certain injured soldiers had to endure delays many hours or even multiple days before they could be transported because of the danger of aerial attacks. “Our facility received a pair of severely injured casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “I’ve been healthcare for 20 years. One must focus,” he said.

Orderlies wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The transport was parked beneath a bush. The patient and the other soldiers were transferred to the city of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s orange feline, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”