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Scrubby trees conceal the entryway. A descending timber tunnel descends to a brightly lit reception area. There is a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus cabinets stocked of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a laundry appliance and kettle, doctors monitor a screen. The screen reveals the flight patterns of enemy spy drones as they zigzag in the sky above.

Hospital staff at an underground hospital look at a monitor showing enemy suicide and surveillance UAVs in the region.

This is Ukraine’s covert below-ground medical facility. 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 below the earth. It’s the safest way of delivering care to our wounded soldiers. And it keeps medical personnel protected,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a each day. Their conditions vary. Some have devastating limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of Russian first-person view (FPV) drones, which drop explosives with lethal accuracy. “90% of our cases are from first-person view drones. We see minimal gunshot wounds. This is an age of drones and a new type of war,” the surgeon explained.

Maj the senior surgeon at the subterranean facility for caring for injured troops in the eastern region.

On one day recently, three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a minor wound in his leg. “War is terrible. The guy next to me, Vasyl, was killed,” he said. “He fell down. Then the enemy forces dropped a second explosive on him.” He continued: “All structures in the settlement is demolished. There are UAVs all around and casualties. Our side's and theirs.”

Dvorskyi explained his squad endured over a month in a forest area near Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to get to their position was by walking. Necessary provisions arrived by quadcopter: food and water. A week after he was hurt, he walked 5km (about 3 miles), requiring three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant provided him with new non-military attire: a T-shirt and a set of pale denim trousers.

The soldier, 28, said a FPV aerial device caused a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been lost. There are continuous detonations.” A builder employed in a neighboring country, Filipchuk said he had returned to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a stained dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A fragment of mortar struck me. It was a ricochet. My condition is stable,” 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 defend our country,” he affirmed.

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

Since 2022, Russia has consistently attacked hospitals, clinics, maternity wards and ambulances. Per human rights groups, 261 health workers have been killed in almost 2,000 assaults. This subterranean hospital is built from four reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It can withstand impacts from 152mm artillery shells and even three eight-kilogram TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, plans to build twenty units in all. The head of Ukraine’s security agency and ex- defence minister, the official, declared they would be “vitally important for preserving the lives of our armed forces and supporting troops on the battlefront.” The organization referred to the project as the “most ambitious and demanding” it had undertaken since the enemy's invasion.

An example of the facility's surgical rooms.

The surgeon, said certain wounded personnel had to wait hours or even multiple days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill patients who arrived at the early hours. It was necessary to perform a double amputation on a patient. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with severe surgeries? “My career in medicine for 20 years. You have to focus,” he said.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked under a bush. He and the other military members were transferred to the urban center of Dnipro for further treatment. The subterranean hospital staff took a break. The facility's ginger cat, the mascot, walked toward the doorway to await the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”