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Sparse trees conceal the entryway. A sloping wooden passageway descends to a brightly lit reception area. There is a operating ward, outfitted with beds, heart rate sensors and breathing machines. Plus shelves stocked of healthcare supplies, medications and neat piles of extra garments. In a staff room with a washing machine and hot water heater, physicians monitor a screen. It shows the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground hospital observe a screen displaying Russian suicide and reconnaissance drones in the region.

Welcome to Ukraine’s secret underground medical facility. The facility began operations in August and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are six meters under the earth. It’s the safest way of providing help to our injured military personnel. And it keeps healthcare workers safe,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty patients a day. Cases differ widely. Some have devastating limb trauma requiring amputations, or serious stomach wounds. Others can move on their own. The vast majority are the victims of Russian FPV aerial devices, which drop explosives with deadly precision. “Ninety per cent of our cases are from FPVs. We encounter few bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the surgeon explained.

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

On one afternoon last week, a group of three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his limb. “War 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 destroyed. There are drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his unit endured 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture since last year. The only way to reach their position was by walking. Necessary provisions came by quadcopter: food and water. A week after he was injured, he traveled 5km (roughly three miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a nurse provided him with fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device caused a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, said a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he said. “I believe I was lucky to survive. My cousin has been killed. We face ongoing explosions.” A builder employed in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a medical cot, took off a bloody bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his family member. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To get better. This may require a few months. After that, to go back to my military group. Someone must protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Over the past years, enemy forces has consistently attacked hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 health workers have been killed in almost 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist impacts from 152mm projectiles and even multiple eight-kilogram explosive devices dropped by drone.

A major steel and mining company, which financed the building, intends to build twenty units in all. The head of Ukraine’s security agency and former defence minister, the official, declared they would be “vitally important for saving the survival of our military and assisting defenders on the battlefront.” The organization referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

One of the facility's surgical rooms.

The surgeon, explained some injured soldiers had to wait hours or even days before they could be transported due to the danger of air assaults. “We had two severely injured patients who came at 3am. It was necessary to carry out a removal of both limbs on a patient. The soldier's tourniquet had been applied for so long there was no alternative.” How did he cope with severe surgeries? “My career in medicine for 20 years. One must focus,” he said.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was parked under a shrub. The patient and the two other military members were taken to the city of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, Vasilevs, padded toward the entrance to await the next arrivals. “We are open around the clock,” the surgeon stated. “The work is continuous.”