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Scrubby trees conceal the entryway. A descending timber tunnel descends to a brightly lit welcome zone. Inside lies a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and kettle, doctors monitor a display. The screen reveals the movements of enemy spy drones as they zigzag in the air above.

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

This is Ukraine’s covert underground hospital. The facility began operations in the eighth month and is the second of its kind, located in the eastern part of the country close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. It’s the most secure method of delivering care to our injured military personnel. It also ensures medical personnel safe,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring amputations, or severe abdominal injuries. Some patients can move on their own. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which release explosives with lethal precision. “90% of our cases are from first-person view drones. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the surgeon said.

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

On one afternoon last week, three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a minor wound in his leg. “War is horrific. My comrade beside me, Vasyl, was killed,” he stated. “He collapsed. Then the Russians dropped a another grenade on him.” He added: “Everything in the village is destroyed. There are UAVs everywhere and bodies. Ours and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone near Pokrovsk, which Russia has been trying to seize since last year. Sole access to get to their location was by walking. All supplies came by quadcopter: rations and water. Seven days after he was hurt, he traveled 5km (roughly three miles), requiring several hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse gave him new non-military attire: a T-shirt and a set of light-colored jeans.

The soldier, twenty-eight, stated a FPV aerial device caused a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. My cousin has been lost. There are continuous explosions.” A builder employed in a neighboring country, Filipchuk said he had returned to Ukraine and volunteered to fight shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a medical cot, took off a stained dressing and cleaned his recent injury from fragments. Covered in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of mortar hit me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. That will take a few months. After that, to go back to my military group. Someone must protect our nation,” he said.

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

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and ambulances. Per international monitors, over two hundred health workers have been killed in almost two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, soil and sand laid on top up to ground level. It can withstand impacts from 152mm projectiles and even three 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the construction, plans to build twenty units in all. A senior official of the nation's security agency and former military leader, the official, said they would be “vitally important for saving the survival of our armed forces and supporting defenders on the frontline.” The organization referred to the project as the “most ambitious and challenging” it had undertaken since Russia’s invasion.

An example of the centre’s surgical rooms.

The surgeon, explained certain wounded personnel had to wait hours or even multiple days before they could be transported because of the threat of aerial attacks. “Our facility received two severely injured casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” What is his method with severe operations? “My career in healthcare for two decades. One must focus,” he remarked.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The vehicle was stationed beneath a bush. The patient and the two other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, padded up to the doorway to greet the next arrivals. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”