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Scrubby foliage conceal the entryway. A descending timber tunnel leads down to a brightly lit reception area. There is a operating ward, equipped with beds, cardiac monitors and breathing machines. And shelves stocked of medical equipment, drugs and organized stacks of extra garments. In a break area with a washing machine and kettle, doctors monitor a screen. The screen reveals the movements of Russian spy drones as they zigzag in the sky above.

Medical personnel at an underground medical center observe a screen displaying Russian kamikaze and surveillance UAVs in the region.

This is Ukraine’s secret below-ground hospital. This center opened in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of Pokrovsk in the Donetsk region. “We are 6 metres below the ground. This is the most secure way of delivering care to our wounded soldiers. It also ensures medical personnel protected,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which release explosives with lethal precision. “90% of our cases are from first-person view drones. We see few bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Major Oleksandr Holovashchenko at the underground installation for treating injured soldiers in eastern Ukraine.

During one day recently, a group of three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, reported an FPV explosion had ripped a small hole in his leg. “War is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the Russians released a second grenade on him.” He added: “Everything in the settlement is destroyed. There are UAVs everywhere and casualties. Our side's and theirs.”

The soldier said his squad endured over a month in a wooded zone near the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was on foot. All supplies came by quadcopter: rations and water. Seven days after he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. After treatment, a medical attendant gave him new civilian clothes: a T-shirt and a pair of light-colored denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “My position was in a dugout. It suddenly became black. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to survive. A relative has been killed. There are continuous detonations.” A construction worker employed in Lithuania, Filipchuk said he had come back to Ukraine and volunteered to fight shortly before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff placed him on a medical cot, took off a bloody bandage and cleaned his recent injury from fragments. Covered in a thermal sheet, he used a mobile phone to ring his sister. “A piece of mortar hit me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to return to my unit. Our forces must defend our nation,” he said.

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

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 medical personnel have been fatally attacked in nearly two thousand attacks. This subterranean hospital is constructed from four steel bunkers, with wooden supports, earth and sand laid on top up to ground level. It can withstand direct hits from large-caliber projectiles and even three eight-kilogram TNT charges dropped by aerial means.

A major steel and mining company, which funded the building, plans to build 20 facilities in total. A senior official of the nation's national security council and former military leader, the official, declared they would be “vitally essential for preserving the lives of our military and supporting defenders on the frontline.” The organization described the initiative as the “largest-scale and challenging” it had undertaken after the enemy's invasion.

One of the facility's surgical rooms.

The surgeon, explained certain injured soldiers had to endure delays hours or even days before they could be evacuated because of the danger of aerial attacks. “We had two severely injured casualties who arrived at the early hours. I had to carry out a double amputation on one of them. The soldier's bleeding control device had been applied for so long there was no other option.” What is his method with traumatic operations? “I’ve been medicine for two decades. One must focus,” he said.

Medical assistants transported Mykolaichuk through the passage and into an ambulance. The vehicle was stationed beneath a bush. He and the other military members were taken to the urban center of a major city for further treatment. The underground medical team paused for rest. The facility's orange feline, the mascot, padded up to the doorway to await the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”