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Scrubby trees conceal the entrance. One descending wooden passageway leads down to a brightly lit reception area. Inside lies a operating ward, outfitted with beds, heart rate sensors and ventilators. And cabinets full of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an subterranean hospital observe a screen displaying enemy kamikaze and surveillance drones in the region.

This is Ukraine’s covert below-ground medical facility. This center opened in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of Pokrovsk in the Donetsk region. “We are 6 metres below the earth. This is the safest way of delivering care to our injured soldiers. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which release grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We see few gunshot wounds. It’s an age of unmanned aircraft and a new type of war,” the doctor said.

Major the senior surgeon at the subterranean installation for caring for injured troops in eastern Ukraine.

During one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old one soldier, said an first-person view drone blast had torn a small hole in his limb. “War is horrific. My comrade next to me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians released a second grenade on him.” He continued: “All structures in the settlement is destroyed. There are drones all around and casualties. Ours and theirs.”

The soldier said his unit endured over a month in a wooded zone close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week after he was hurt, he traveled five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medic assessed his physical condition. After treatment, a nurse provided him with new non-military attire: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device ripped a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or any sound,” he said. “I think I was fortunate to survive. My cousin has been lost. We face ongoing detonations.” A builder working in Lithuania, he noted he had returned to Ukraine and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He groaned as medical staff placed him on a medical cot, took off a stained dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his family member. “A fragment of mortar hit me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to return to my unit. Our forces must protect our country,” he affirmed.

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

Since 2022, enemy forces has repeatedly targeted medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 health workers have been fatally attacked in almost 2,000 assaults. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and granular material laid on top reaching ground level. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg explosive devices dropped by drone.

The Ukrainian steel and mining company, which financed the construction, intends to build twenty units in all. The head of Ukraine’s national security council and former defence minister, the official, said they would be “critically important for saving the survival of our military and assisting defenders on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented since the enemy's military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said some wounded personnel had to wait hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received two severely injured casualties who arrived 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 so long there was no alternative.” What is his method with traumatic operations? “My career in medicine for two decades. You have to focus,” he said.

Orderlies wheeled the soldier through the passage and into an ambulance. The vehicle was stationed beneath a shrub. He and the two other soldiers were taken to the urban center of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded up to the doorway to await the next arrivals. “We are open around the clock,” Holovashchenko said. “The work is continuous.”