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Sparse foliage conceal the entryway. A sloping wooden tunnel leads down to a well-illuminated reception area. Inside lies a operating ward, equipped with beds, cardiac monitors and ventilators. And shelves stocked of medical equipment, drugs and neat piles of extra garments. Within a staff room with a laundry appliance and kettle, doctors monitor a display. It shows the movements of enemy spy drones as they zigzag in the air above.

Hospital personnel at an underground hospital look at a monitor displaying enemy kamikaze and reconnaissance drones in the area.

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 close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the ground. This is the safest way of delivering care to our wounded military personnel. It also ensures medical personnel protected,” said the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Their conditions vary. Some have catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Some patients can move on their own. The vast majority are the victims of Russian first-person view (FPV) drones, which drop explosives with deadly accuracy. “Ninety per cent of our cases are from FPVs. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the subterranean installation for treating injured soldiers in eastern Ukraine.

On one afternoon last week, a group of three soldiers limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his leg. “War is horrific. My comrade beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the village is demolished. We see UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his unit endured over a month in a forest area near Pokrovsk, which Russia has been trying to seize since last year. Sole access to get to their position was by walking. All supplies came by quadcopter: food and water. A week following he was injured, he traveled 5km (roughly three miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV drone ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or hear anything,” he said. “I think I was lucky to survive. A relative has been lost. We face ongoing detonations.” A construction worker working in Lithuania, he said he had returned to Ukraine and enlisted to serve days 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, took off a stained bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a mobile phone to call his family member. “A fragment of mortar hit me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. This may require a several months. Subsequently, to go back to my unit. Someone must defend our nation,” he said.

Doctors care for the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly attacked medical centers, health facilities, maternity wards and ambulances. According to international monitors, over two hundred health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and granular material laid on top up to ground level. It is designed to resist impacts from large-caliber artillery shells and even three 8kg explosive devices dropped by drone.

A major steel and mining company, which funded the construction, plans to erect twenty facilities in total. The head of the nation's security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for preserving the survival of our armed forces and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

An example of the facility's surgical rooms.

The surgeon, said some wounded personnel had to wait hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had a pair of critically ill patients who came at the early hours. I had to carry out a removal of both limbs on one of them. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with traumatic surgeries? “I’ve been medicine for two decades. You have to concentrate,” he remarked.

Orderlies wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the other military members were transferred to the city of a major city for additional medical care. The subterranean hospital staff took a break. The facility's orange feline, the mascot, walked toward the entrance to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko stated. “The work is continuous.”