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Sparse trees hide the entryway. A sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and breathing machines. And shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a staff room with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital personnel at an subterranean hospital look at a screen showing Russian suicide and reconnaissance UAVs in the region.

This is the nation's secret underground hospital. The facility opened in August and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. This is the safest method of providing help to our wounded military personnel. It also ensures medical personnel protected,” said the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point treats 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or serious abdominal injuries. Others can move on their own. Almost all are the victims of Russian FPV drones, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We see few gunshot wounds. This is an era of drones and a different kind of war,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean installation for treating injured troops in eastern Ukraine.

During one afternoon recently, three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “Everything in the settlement is destroyed. There are UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad spent over a month in a forest area near the city, which Russia has been attempting to capture since last year. Sole access to get to their location was by walking. All supplies came by quadcopter: food and water. A week after he was injured, he walked five kilometers (roughly three miles), requiring several hours, to where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a nurse gave him new civilian clothes: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a dugout. It suddenly became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been lost. There are continuous explosions.” A construction worker employed in a neighboring country, he said he had returned to his homeland and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff laid him on a medical cot, removed a bloody bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A fragment of artillery hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a few months. Subsequently, to go back to my military group. Our forces has to protect our country,” he affirmed.

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

Over the past years, enemy forces has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. Per international monitors, over two hundred medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is built from multiple steel bunkers, with wooden supports, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from large-caliber artillery shells and even multiple eight-kilogram explosive devices dropped by aerial means.

The Ukrainian industrial group, which financed the building, plans to erect twenty units in total. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “critically essential for preserving the lives of our military and supporting defenders on the battlefront.” The organization described the project as the “largest-scale and demanding” it had undertaken after the enemy's military offensive.

One of the centre’s surgical rooms.

The surgeon, said some injured soldiers had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had two critically ill casualties who came at the early hours. I had to carry out a removal of both limbs on a patient. His bleeding control device had been on for such an extended period there was no alternative.” What is his method with traumatic surgeries? “My career in medicine for two decades. One must concentrate,” he said.

Orderlies transported Mykolaichuk through the tunnel and into an ambulance. The vehicle was stationed under a shrub. The patient and the two other military members were taken to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's ginger cat, Vasilevs, padded up to the doorway to greet the incoming patients. “We are active around the clock,” the surgeon said. “It doesn’t stop.”