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Scrubby trees conceal the entryway. A sloping timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves stocked of medical equipment, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Hospital personnel at an underground medical center look at a monitor showing Russian kamikaze and surveillance UAVs in the region.

Welcome to Ukraine’s covert underground hospital. The facility opened in August and is the second of its kind, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres under the ground. It’s the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” stated the facility's surgeon, Maj the chief surgeon.

This medical station handles 30-40 patients a day. Cases differ widely. Some have catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which release explosives with deadly accuracy. “90% of our cases are from first-person view drones. We encounter few bullet injuries. It’s an era of drones 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 walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a small hole in his leg. “Conflict is horrific. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a second grenade on him.” He added: “Everything in the settlement is destroyed. We see drones everywhere and bodies. Ours and the enemy's.”

The soldier said his unit spent 43 days in a wooded zone near Pokrovsk, which Russia has been attempting to capture for many months. Sole access to reach their location was on foot. All supplies came by drone: food and water. Seven days after he was hurt, he traveled five kilometers (roughly three miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him new civilian clothes: a T-shirt and a set of pale jeans.

The soldier, 28, stated a first-person view aerial device ripped a small hole in his leg.

Another patient, thirty-eight-year-old a serviceman, said a drone blast had left him with a head injury. “My position was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. We face ongoing explosions.” A builder working in a neighboring country, he noted he had come back to Ukraine and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as medical staff laid him on a medical cot, took off a stained bandage and cleaned his recent shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a several months. Subsequently, to return to my military group. Someone must defend our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Over the past years, Russia has repeatedly attacked medical centers, clinics, maternity wards and ambulances. Per human rights groups, 261 health workers have been fatally attacked in nearly 2,000 assaults. The underground facility is built from multiple reinforced shelters, with wooden supports, earth and granular material placed above up to ground level. It can withstand impacts from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which funded the building, intends to erect 20 units in total. The head of Ukraine’s security agency and former defence minister, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and supporting troops on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken after the enemy's military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said certain wounded personnel had to endure delays hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of critically ill casualties who came at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no other option.” How did he cope with severe operations? “My career in medicine for two decades. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier up the passage and into an ambulance. The vehicle was stationed under a bush. The patient and the two other military members were taken to the city of a major city for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, Vasilevs, walked toward the entrance to await the incoming patients. “Our facility operates active around the clock,” the surgeon stated. “The work is continuous.”