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Sparse foliage conceal the entrance. One sloping wooden passageway descends to a brightly lit reception area. There is a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, medications and organized stacks of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the movements of enemy spy drones as they weave in the air above.

Hospital personnel at an subterranean hospital look at a screen showing Russian suicide and surveillance drones in the region.

Welcome to Ukraine’s covert below-ground hospital. This center opened in August and is the second of its kind, located in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the safest way of providing help to our injured soldiers. It also ensures medical personnel safe,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or severe stomach wounds. Others can move on their own. Almost all are the casualties of enemy FPV drones, which release grenades with deadly accuracy. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for injured troops in eastern Ukraine.

On one day last week, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old one soldier, said an FPV explosion had torn a minor wound in his limb. “Conflict is horrific. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Then the enemy forces released a second grenade on him.” He continued: “All structures in the settlement is destroyed. There are UAVs all around and bodies. Ours and theirs.”

Dvorskyi said his squad endured over a month in a forest area close to the city, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week after he was hurt, he walked 5km (about 3 miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his physical condition. After treatment, a nurse gave him new non-military attire: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device ripped a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been lost. There are ongoing explosions.” A builder working in a neighboring country, he said he had returned to his homeland and enlisted to fight shortly before the Russian leader's large-scale attack in early 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff laid him on a bed, took off a bloody bandage and treated his two-day-old shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to call his sister. “A piece of artillery hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a several months. Subsequently, to return to my unit. Someone must protect our country,” he said.

Doctors treat the wounded soldier, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently attacked medical centers, health facilities, maternity wards and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost 2,000 assaults. The underground facility is built from multiple reinforced shelters, with timber beams, soil and granular material placed above up to the surface. It is designed to resist direct hits from large-caliber artillery shells and even multiple eight-kilogram explosive devices released by drone.

A major steel and mining company, which financed the construction, plans to erect twenty units in total. A senior official of Ukraine’s security agency and former defence minister, the official, declared they would be “critically essential for preserving the lives of our armed forces and assisting defenders on the battlefront.” The company referred to the project as the “most ambitious and challenging” it had undertaken since the enemy's invasion.

One of the centre’s operating theatres.

The surgeon, explained certain injured soldiers had to endure delays hours or even days before they could be transported because of the threat of air assaults. “Our facility received a pair of critically ill patients who came at 3am. I had to carry out a double amputation on one of them. His tourniquet had been applied for so long there was no alternative.” What is his method with severe operations? “My career in healthcare for two decades. One must focus,” he said.

Medical assistants wheeled the soldier up the passage and into an ambulance. The vehicle was stationed beneath a bush. He and the two other military members were transferred to the city of Dnipro for further treatment. The underground hospital staff paused for rest. The facility's ginger cat, Vasilevs, walked up to the entrance to greet the next arrivals. “Our facility operates active around the clock,” Holovashchenko stated. “It doesn’t stop.”