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Scrubby trees hide the entrance. One descending timber passageway leads down to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus cabinets stocked of medical equipment, drugs and organized stacks of extra garments. In a break area with a laundry appliance and kettle, doctors monitor a screen. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

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

This is Ukraine’s covert below-ground hospital. The facility opened in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits six meters below the earth. This is the safest method of providing help to our wounded soldiers. And it keeps medical personnel safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station handles 30-40 patients a day. Cases differ widely. Some have devastating leg injuries necessitating amputations, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of enemy FPV drones, which drop explosives with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter minimal bullet injuries. This is an age of unmanned aircraft and a new type of war,” the surgeon said.

Maj the senior surgeon at the subterranean facility for treating wounded soldiers in eastern Ukraine.

During one day last week, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV explosion had torn a small hole in his leg. “War is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Subsequently the enemy forces released a another explosive on him.” He continued: “Everything in the settlement is demolished. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi explained his squad spent 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their location was on foot. Necessary provisions came by drone: food and drinking water. Seven days after he was injured, he traveled 5km (roughly three miles), taking three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medical staff checked his vital signs. After treatment, a medical attendant gave him new civilian clothes: a T-shirt and a set of pale jeans.

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

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “I was in a dugout. It suddenly became black. I couldn’t feel anything or any sound,” he said. “I think I was fortunate to survive. A relative has been killed. There are ongoing detonations.” A construction worker employed in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to fight shortly before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a bed, took off a stained bandage and treated his recent injury from fragments. Covered in a foil blanket, he used a cellphone to call his sister. “A fragment of artillery struck me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. That will take a several months. After that, to go back to my military group. Someone must protect our nation,” he affirmed.

Medical staff care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly attacked medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, 261 medical personnel have been killed in nearly 2,000 attacks. This subterranean hospital is built from multiple steel bunkers, with wooden supports, soil and granular material placed above up to the surface. It can withstand impacts from 152mm projectiles and even three 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, intends to erect 20 units in total. A senior official of the nation's security agency and ex- military leader, the official, said they would be “critically important for saving the lives of our armed forces and assisting troops on the battlefront.” The organization described the project as the “most ambitious and demanding” it had undertaken after the enemy's military offensive.

One of the facility's operating theatres.

The surgeon, said certain wounded soldiers had to endure delays hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received two severely injured casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on a patient. The soldier's bleeding control device had been on for so long there was no other option.” How did he cope with traumatic operations? “My career in medicine for 20 years. You have to concentrate,” he remarked.

Orderlies transported the soldier through the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other military members were taken to the urban center of a major city for further treatment. The subterranean medical team took a break. The hospital’s orange feline, the mascot, padded up to the doorway to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”