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Scrubby foliage hide the entrance. One sloping timber tunnel descends to a brightly lit reception area. There is a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. Plus shelves stocked of medical equipment, medications and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, doctors monitor a display. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground hospital observe a screen showing enemy kamikaze and surveillance drones in the area.

Welcome to Ukraine’s secret below-ground hospital. This center began operations in the eighth month and is the second such installation, located in eastern Ukraine close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are six meters below the ground. It’s the safest way of providing help to our wounded soldiers. And it keeps healthcare workers protected,” stated the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring amputations, or severe abdominal injuries. Some patients can move on their own. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which release explosives with deadly accuracy. “Ninety per cent of our cases are from FPVs. We see minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured troops in eastern Ukraine.

On one afternoon recently, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had torn a small hole in his leg. “Conflict is horrific. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the Russians dropped a second explosive on him.” He continued: “Everything in the village is demolished. We see UAVs all around and bodies. Our side's and theirs.”

Dvorskyi said his squad endured over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their position was on foot. Necessary provisions arrived by drone: food and drinking water. Seven days after he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his physical condition. Following care, a nurse provided him with new non-military attire: a T-shirt and a set of light-colored jeans.

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

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “I was in a dugout. It suddenly became black. I lost sensation anything or any sound,” he explained. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous explosions.” A builder working in Lithuania, he noted he had returned to Ukraine and enlisted to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors placed him on a medical cot, removed a stained bandage and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A piece of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to return to my unit. Someone has to protect our country,” he said.

Medical staff treat the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Since 2022, enemy forces has consistently targeted medical centers, clinics, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been fatally attacked in nearly two thousand attacks. The underground facility is built from multiple reinforced shelters, with wooden supports, soil and granular material placed above up to ground level. It can withstand impacts from 152mm projectiles and even three 8kg TNT charges released by aerial means.

A major steel and mining company, which funded the building, intends to build 20 facilities in all. A senior official of Ukraine’s security agency and former military leader, the official, said they would be “critically important for saving the survival of our military and assisting defenders on the battlefront.” The organization described the initiative as the “largest-scale and demanding” it had undertaken since the enemy's military offensive.

One of the centre’s operating theatres.

The surgeon, said some wounded soldiers had to wait many hours or even multiple days before they could be transported because of the threat of aerial attacks. “We had two critically ill patients who arrived at 3am. I had to perform a double amputation on a patient. His tourniquet had been on for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been healthcare for 20 years. You have to concentrate,” he remarked.

Orderlies transported Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the two other soldiers were taken to the city of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's orange feline, Vasilevs, walked toward the doorway to await the next arrivals. “We are open 24 hours a day,” the surgeon stated. “It doesn’t stop.”