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Scrubby trees hide the entryway. One sloping wooden tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, equipped with beds, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, drugs and neat piles of extra garments. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Medical personnel at an subterranean medical center observe a screen showing enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s secret below-ground hospital. The facility began operations in the eighth month 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. “Our facility sits 6 metres under the ground. This is the most secure way of providing help to our injured soldiers. It also ensures medical personnel protected,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a each day. Their conditions vary. Some have devastating limb trauma requiring surgical removal, or serious abdominal injuries. Others can walk. Almost all are the casualties of enemy FPV aerial devices, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We encounter few gunshot wounds. This is an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Major the senior surgeon at the subterranean installation for caring for wounded soldiers in the eastern region.

On one afternoon last week, three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone explosion had ripped a small hole in his limb. “Conflict is horrific. My comrade next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces dropped a second explosive on him.” He continued: “Everything in the village is demolished. We see UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi said his squad spent 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their position was by walking. All supplies arrived by drone: rations and water. Seven days after he was injured, he traveled five kilometers (roughly three miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his physical condition. Following care, a medical attendant provided him with fresh civilian clothes: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, stated a FPV drone caused a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly became black. I couldn’t feel anything or any sound,” he said. “I believe I was lucky to remain alive. A relative has been lost. We face ongoing detonations.” A construction worker working in Lithuania, he noted he had come back to his homeland and enlisted to serve days before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been hit in the back. He groaned as medical staff placed him on a medical cot, took off a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his family member. “A piece of artillery struck me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. This may require a several months. Subsequently, to go back to my military group. Our forces has to defend our country,” he said.

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

Since 2022, enemy forces has consistently attacked medical centers, clinics, maternity wards and emergency vehicles. According to human rights groups, 261 health workers have been killed in almost two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and sand laid on top reaching ground level. It can withstand impacts from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which funded the construction, plans to erect twenty facilities in all. A senior official of Ukraine’s national security council and ex- military leader, Rustem Umerov, declared they would be “vitally important for saving the lives of our armed forces and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, explained some injured soldiers had to endure delays many hours or even days before they could be evacuated because of the danger of aerial attacks. “We had two severely injured casualties who came at 3am. I had to carry out a removal of both limbs on one of them. His tourniquet had been on for such an extended period there was no alternative.” What is his method with traumatic surgeries? “I’ve been medicine for 20 years. One must concentrate,” he said.

Medical assistants transported the soldier through the passage and into an ambulance. The transport was parked under a shrub. The patient and the two other military members were transferred to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, walked up to the doorway to await the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko stated. “The work is continuous.”