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Sparse trees conceal the entryway. One sloping wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of medical equipment, medications and neat piles of extra garments. Within a break area with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital staff at an underground hospital look at a screen showing enemy suicide and surveillance drones in the area.

Welcome to the nation's covert below-ground hospital. This center opened 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 city of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. It’s the safest way of providing help to our injured military personnel. And it keeps medical personnel safe,” stated the clinic’s lead doctor, Major the chief surgeon.

This medical station handles thirty to forty patients a day. Cases differ widely. Some have devastating leg injuries requiring surgical removal, or severe stomach wounds. Some patients can move on their own. The vast majority are the casualties of Russian FPV aerial devices, which drop explosives with lethal accuracy. “Ninety per cent of our patients are from FPVs. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Maj Oleksandr Holovashchenko at the underground installation for treating wounded troops in eastern Ukraine.

During one afternoon last week, three military members limped into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces dropped a another explosive on him.” He added: “All structures in the village is destroyed. We see drones all around and casualties. Ours and theirs.”

The soldier explained his squad endured over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their position was by walking. All supplies arrived by drone: rations and drinking water. A week following he was injured, he traveled five kilometers (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him new civilian clothes: a shirt and a pair of light-colored denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face ongoing explosions.” A builder working in a neighboring country, he said he had returned to his homeland and volunteered to fight days before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a bed, removed a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a several months. Subsequently, to return to my military group. Our forces must defend our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been killed in nearly 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material placed above up to the surface. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram explosive devices dropped by drone.

The Ukrainian industrial group, which funded the construction, intends to erect 20 facilities in all. A senior official of Ukraine’s security agency and former defence minister, Rustem Umerov, said they would be “critically essential for saving the lives of our armed forces and supporting defenders on the frontline.” The organization described the initiative as the “most ambitious and demanding” it had undertaken after the enemy's military offensive.

An example of the centre’s operating theatres.

The surgeon, said some wounded soldiers had to endure delays hours or even days before they could be evacuated because of the danger of air assaults. “Our facility received two critically ill casualties who arrived at the early hours. It was necessary to carry out a double amputation on one of them. The soldier's bleeding control device had been on for such an extended period there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for two decades. One must concentrate,” he said.

Orderlies transported the soldier through the passage and into an ambulance. The vehicle was parked beneath a bush. The patient and the other military members were taken to the city of a major city for further treatment. The underground medical team paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to greet the incoming patients. “Our facility operates open 24 hours a day,” the surgeon said. “It doesn’t stop.”