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Sparse foliage conceal the entryway. A descending timber tunnel descends to a brightly lit reception area. There is a operating ward, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital staff at an underground medical center look at a monitor showing enemy suicide and surveillance UAVs in the region.

Welcome to the nation's covert below-ground hospital. This center opened in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the earth. This is the most secure method of providing help to our injured military personnel. And it keeps medical personnel safe,” stated the facility's lead doctor, Maj the chief surgeon.

The stabilisation point treats thirty to forty patients a day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. The vast majority are the victims of Russian FPV drones, which release grenades with lethal precision. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. This is an era of drones and a new type of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in eastern Ukraine.

On one afternoon recently, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had torn a minor wound in his leg. “War is horrific. My comrade beside me, Vasyl, was killed,” he stated. “He fell down. Then the enemy forces dropped a second explosive on him.” He added: “All structures in the village is destroyed. There are drones everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his squad endured over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their position 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 where an military transport was able to pick him up. At the clinic, a medic checked his vital signs. After treatment, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of pale jeans.

The soldier, 28, said a first-person view aerial device ripped a small hole in his leg.

Another patient, 38-year-old a serviceman, said a drone blast had left him with a head injury. “My position was in a dugout. It suddenly became black. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to survive. My cousin has been lost. There are continuous detonations.” A construction worker employed in a neighboring country, Filipchuk said he had returned to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as doctors placed him on a bed, removed a stained dressing and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to call his sister. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To get better. This may require a few months. Subsequently, to go back to my unit. Someone must protect our nation,” he said.

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

Over the past years, Russia has consistently targeted medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 medical personnel have been killed in almost two thousand attacks. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and granular material laid on top reaching the surface. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, intends to erect 20 facilities in total. The head of the nation's security agency and former defence minister, Rustem Umerov, said they would be “vitally important for preserving the lives of our armed forces and supporting defenders on the battlefront.” The company described the project as the “most ambitious and demanding” it had undertaken after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said some injured personnel had to wait many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “Our facility received two severely injured casualties who came at the early hours. I had to carry out a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “I’ve been healthcare for 20 years. One must focus,” he said.

Medical assistants transported the soldier up the passage and into an ambulance. The vehicle was stationed under a bush. He and the other military members were taken to the urban center of a major city for further treatment. The underground hospital staff took a break. The hospital’s orange feline, Vasilevs, padded toward the entrance to greet the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”