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Scrubby trees hide the entrance. One sloping wooden tunnel descends to a well-illuminated welcome zone. There is a operating ward, equipped with beds, cardiac monitors and ventilators. Plus shelves full of medical equipment, drugs and neat piles of spare clothes. In a break area with a washing machine and kettle, doctors monitor a screen. It shows the movements of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an underground hospital look at a monitor showing Russian kamikaze and surveillance UAVs in the region.

This is the nation's secret below-ground hospital. The facility began operations in August and is the second of its kind, located in the eastern part of the country close to the frontline and the city of Pokrovsk in the Donetsk region. “We are six meters under the ground. This is the most secure method of providing help to our wounded soldiers. And it keeps healthcare workers safe,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of Russian FPV drones, which release explosives with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the doctor said.

Maj the senior surgeon at the subterranean installation for treating wounded troops in the eastern region.

On one day last week, a group of three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a small hole in his leg. “War is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “All structures in the village is destroyed. We see UAVs everywhere and casualties. Ours and theirs.”

Dvorskyi explained his squad spent 43 days in a wooded zone near the city, which enemy forces has been attempting to capture since last year. Sole access to reach their position was on foot. All supplies came by quadcopter: rations and water. A week after he was hurt, he traveled 5km (about 3 miles), taking three hours, to a point where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a pair of pale jeans.

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 concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to survive. My cousin has been lost. There are continuous detonations.” A construction worker working in Lithuania, he said he had returned to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as doctors laid him on a bed, removed a stained bandage and cleaned his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A piece of mortar struck me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my unit. Someone has to protect our country,” he affirmed.

Medical staff treat the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Over the past years, enemy forces has consistently targeted hospitals, health facilities, maternity wards and ambulances. Per international monitors, over two hundred medical personnel have been fatally attacked in nearly two thousand assaults. The underground facility is constructed from four reinforced shelters, with timber beams, earth and granular material laid on top reaching the surface. It is designed to resist impacts from 152mm artillery shells and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, plans to build twenty units in all. The head of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “vitally important for preserving the lives of our armed forces and supporting defenders on the frontline.” The company referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

An example of the facility's operating theatres.

The surgeon, said some wounded personnel had to endure delays many hours or even days before they could be transported because of the threat of aerial attacks. “Our facility received a pair of critically ill patients who came at the early hours. I had to carry out a double amputation on a patient. The soldier's 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 healthcare for 20 years. One must concentrate,” he said.

Orderlies transported the soldier through the tunnel and into an ambulance. The transport was parked beneath a shrub. The patient and the other military members were taken to the urban center of Dnipro for further treatment. The underground hospital staff paused for rest. The hospital’s ginger cat, Vasilevs, padded up to the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko said. “The work is continuous.”