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Sparse foliage hide the entrance. A descending timber passageway leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, heart rate sensors and ventilators. And shelves stocked of medical equipment, drugs and neat piles of spare clothes. In a staff room with a washing machine and kettle, physicians keep an eye on a display. The screen reveals the movements of enemy spy drones as they weave in the air above.

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

Welcome to Ukraine’s secret underground hospital. The facility opened in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure method of providing help to our injured soldiers. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a each day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or serious stomach wounds. Others can walk. Almost all are the victims of enemy FPV aerial devices, which release grenades with lethal precision. “90% of our patients are from FPVs. We see few gunshot wounds. It’s an era of drones and a different kind of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for treating injured soldiers in the eastern region.

On one day recently, a group of three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his limb. “Conflict is terrible. The guy beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “All structures in the settlement is demolished. There are UAVs all around and casualties. Our side's and theirs.”

The soldier said his unit endured 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. Sole access to reach their location was by walking. Necessary provisions came by drone: rations and drinking water. Seven days following he was hurt, he walked five kilometers (about 3 miles), taking several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him fresh non-military attire: a T-shirt and a set of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. There are continuous explosions.” A builder employed in a neighboring country, he noted he had returned to his homeland and enlisted to serve shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a medical cot, removed a stained bandage and cleaned his recent injury from fragments. Covered in a thermal sheet, he used a cellphone to ring his sister. “A fragment of mortar hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. This may require a several months. Subsequently, to go back to my unit. Someone must protect our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, obstetric units and ambulances. Per human rights groups, 261 medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is built from multiple reinforced shelters, with timber beams, soil and sand placed above reaching the surface. It can withstand impacts from 152mm artillery shells and even multiple 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which funded the building, intends to build 20 facilities in total. The head of Ukraine’s security agency and former defence minister, the official, said they would be “critically important for preserving the survival of our military and assisting defenders on the battlefront.” The organization referred to the project as the “most ambitious and challenging” it had implemented after Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained some injured soldiers had to wait hours or even days before they could be transported because of the threat of air assaults. “Our facility received two critically ill casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been applied for so long there was no other option.” How did he cope with severe operations? “My career in healthcare for two decades. You have to concentrate,” he said.

Medical assistants transported Mykolaichuk through the passage and into an emergency vehicle. The transport was parked beneath a bush. He and the two other military members were taken to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The facility's ginger cat, the mascot, walked toward the entrance to greet the incoming patients. “Our facility operates open 24 hours a day,” the surgeon said. “The work is continuous.”