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Sparse foliage conceal the entrance. One sloping wooden tunnel descends to a brightly lit welcome zone. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, physicians keep an eye on 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 screen showing Russian kamikaze and reconnaissance drones in the area.

This is Ukraine’s covert below-ground hospital. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country close to the frontline and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the ground. It’s the most secure method of providing help to our wounded soldiers. It also ensures healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point handles thirty to forty casualties a day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or serious abdominal injuries. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our patients are from first-person view drones. We encounter few gunshot wounds. This is an era of unmanned aircraft and a new type of war,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean installation for treating wounded soldiers in eastern Ukraine.

On one day recently, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an FPV blast had ripped a minor wound in his leg. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “All structures in the village is demolished. We see drones all around and casualties. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to get to their position was by walking. Necessary provisions came by quadcopter: food and water. Seven days after he was injured, he traveled 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his physical condition. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a set of pale jeans.

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

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “My position was in a dugout. It suddenly became black. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been killed. There are ongoing explosions.” A construction worker employed in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to fight days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors placed him on a bed, removed a stained bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to call his sister. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a few months. Subsequently, to go back to my military group. Our forces has to defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has consistently attacked medical centers, health facilities, obstetric units and emergency vehicles. According to human rights groups, over two hundred health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, soil and granular material laid on top up to ground level. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which funded the building, plans to erect 20 facilities in total. A senior official of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “vitally essential for saving the survival of our armed forces and assisting defenders on the frontline.” The company referred to the initiative as the “largest-scale and demanding” it had implemented after the enemy's invasion.

An example of the centre’s surgical rooms.

The surgeon, said certain injured soldiers had to endure delays many hours or even multiple days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill patients who came at 3am. I had to perform a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no other option.” How did he cope with severe surgeries? “My career in medicine for two decades. One must focus,” he said.

Orderlies wheeled Mykolaichuk through the tunnel and into an ambulance. The vehicle was parked beneath a bush. The patient and the other military members were taken to the urban center of Dnipro for additional medical care. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded toward the entrance to greet the incoming patients. “Our facility operates open around the clock,” Holovashchenko said. “The work is continuous.”