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Sparse foliage conceal the entryway. A sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a washing machine and kettle, physicians monitor a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the air above.

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

This is Ukraine’s secret below-ground hospital. The facility began operations in August and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters under the earth. It’s the most secure method of delivering care to our injured military personnel. And it keeps medical personnel protected,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring amputations, or severe stomach wounds. Some patients can move on their own. The vast majority are the casualties of enemy first-person view (FPV) drones, which release grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We encounter few gunshot wounds. It’s an age of drones and a new type of war,” the doctor explained.

Maj the senior surgeon at the underground installation for treating injured soldiers in the eastern region.

During one day recently, three military members limped into the facility. The least severely hurt, 28-year-old one soldier, said an FPV blast had ripped a minor wound in his limb. “War is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a another explosive on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

The soldier said his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. The only way to reach their position was by walking. All supplies arrived by drone: food and water. A week after he was hurt, he walked five kilometers (roughly three miles), taking three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse gave him fresh non-military attire: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, said a first-person view drone caused a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “My position was in a trench shelter. It suddenly became black. I lost sensation any feeling or hear anything,” he said. “I think I was lucky to survive. A relative has been lost. We face ongoing explosions.” A construction worker employed in Lithuania, Filipchuk said he had come back to his homeland and enlisted to fight shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors placed him on a bed, took off a bloody bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a several months. Subsequently, to return to my unit. Someone has to defend our nation,” he affirmed.

Doctors care for the wounded soldier, who was hit in the back by a piece of mortar.

Since 2022, Russia has repeatedly attacked hospitals, clinics, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been killed in nearly two thousand attacks. The underground facility is built from four reinforced shelters, with timber beams, soil and sand laid on top up to the surface. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which financed the building, plans to build twenty facilities in all. The head of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “vitally essential for preserving the survival of our military and supporting defenders on the frontline.” The company described the initiative as the “most ambitious and challenging” it had undertaken since Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained certain injured soldiers had to wait hours or even multiple days before they could be transported because of the threat of aerial attacks. “We had a pair of critically ill patients who came at the early hours. I had to perform a double amputation on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with traumatic operations? “My career in healthcare for 20 years. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk through the tunnel and into an ambulance. The vehicle was parked beneath a bush. He and the other military members were taken to the city of Dnipro for additional medical care. The underground medical team paused for rest. The facility's ginger cat, the mascot, padded toward the entrance to greet the incoming patients. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”