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Scrubby trees conceal the entrance. One descending timber passageway descends to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets stocked of healthcare supplies, drugs and neat piles of extra garments. Within a break area with a washing machine and hot water heater, doctors keep an eye on a display. It shows the flight patterns of Russian spy drones as they zigzag in the sky above.

Hospital personnel at an underground medical center look at a screen showing enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s secret below-ground hospital. The facility opened in August and is the second such installation, located in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. It’s the most secure method of delivering care to our wounded military personnel. It also ensures healthcare workers safe,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma requiring amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the victims of Russian FPV aerial devices, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We see few gunshot wounds. This is an age of unmanned aircraft and a new type of war,” the surgeon explained.

Maj the senior surgeon at the underground installation for treating wounded soldiers in the eastern region.

During one afternoon last week, three military members walked with difficulty into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his limb. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces dropped a second explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi said his unit spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. Sole access to reach their position was by walking. All supplies came by drone: food and water. Seven days following he was injured, he traveled 5km (about 3 miles), taking several hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. Following care, a nurse gave him new non-military attire: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a small hole in his leg.

A different casualty, 38-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. It suddenly became black. I couldn’t feel anything or any sound,” he said. “I believe I was fortunate to survive. My cousin has been killed. There are continuous explosions.” A builder employed in Lithuania, he said he had returned to his homeland and volunteered to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, took off a bloody bandage and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A piece of artillery hit me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. After that, to return to my unit. Our forces has to protect our country,” he said.

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

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, obstetric units and ambulances. According to international monitors, over two hundred medical personnel have been killed in nearly two thousand attacks. The underground facility is built from multiple reinforced shelters, with timber beams, earth and granular material laid on top reaching the surface. It can withstand direct hits from 152mm artillery shells and even three 8kg explosive devices dropped by aerial means.

A major steel and mining company, which financed the construction, plans to build twenty units in total. The head of the nation's security agency and ex- military leader, the official, said they would be “vitally essential for preserving the survival of our armed forces and supporting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken after the enemy's military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, explained some injured soldiers had to wait many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had a pair of critically ill casualties who came at the early hours. It was necessary to perform a double amputation on a patient. The soldier's tourniquet had been on for such an extended period there was no alternative.” How did he cope with severe operations? “My career in medicine for two decades. One must concentrate,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked beneath a shrub. He and the other military members were taken to the urban center of a major city for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, the mascot, walked up to the doorway to await the incoming patients. “Our facility operates active 24 hours a day,” the surgeon stated. “The work is continuous.”