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Sparse trees conceal the entrance. A descending wooden tunnel descends to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And shelves full of healthcare supplies, medications and organized stacks of extra garments. Within a break area with a washing machine and hot water heater, doctors monitor a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical personnel at an underground hospital observe a screen displaying Russian suicide and reconnaissance UAVs in the area.

This is Ukraine’s covert underground hospital. This center began operations in the eighth month and is the second of its kind, located in the eastern part of the country close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. This is the safest method of providing help to our wounded soldiers. It also ensures healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Their conditions vary. Some have devastating leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. The vast majority are the victims of enemy FPV aerial devices, which release grenades with lethal precision. “90% of our cases are from first-person view drones. We see few gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the surgeon said.

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

On one afternoon last week, three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had ripped a small hole in his limb. “Conflict is terrible. My comrade beside me, Vasyl, was killed,” he said. “He fell down. Then the enemy forces released a another explosive on him.” He continued: “All structures in the settlement is demolished. We see UAVs all around and bodies. Ours and the enemy's.”

The soldier explained his unit spent over a month in a wooded zone near the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. All supplies arrived by drone: food and drinking water. Seven days following he was hurt, 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. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a set of light-colored jeans.

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

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. There are continuous explosions.” A builder employed in a neighboring country, he noted he had come back to Ukraine and enlisted to serve shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a medical cot, took off a stained dressing and treated his recent shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of artillery struck me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. That will take a several months. After that, to go back to my military group. Our forces must defend our nation,” he said.

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

Over the past years, Russia has consistently targeted hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, over two hundred health workers have been killed in almost 2,000 attacks. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and sand laid on top up to ground level. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram explosive devices released by drone.

The Ukrainian industrial group, which funded the construction, plans to erect 20 facilities in total. The head of Ukraine’s national security council and ex- defence minister, the official, said they would be “vitally essential for preserving the survival of our military and supporting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken since the enemy's invasion.

One of the centre’s operating theatres.

Holovashchenko, explained certain wounded personnel had to endure delays many hours or even days before they could be evacuated due to the danger of air assaults. “Our facility received two critically ill casualties who came at the early hours. It was necessary to carry out a double amputation on one of them. The soldier's tourniquet 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. You have to focus,” he said.

Medical assistants transported the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a bush. The patient and the two other military members were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The facility's orange feline, the mascot, walked up to the entrance to greet the next arrivals. “We are active 24 hours a day,” the surgeon said. “The work is continuous.”