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Scrubby trees hide the entryway. A descending timber passageway descends to a brightly lit reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. And shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and kettle, physicians monitor a display. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Hospital personnel at an subterranean medical center observe a screen displaying Russian kamikaze and reconnaissance drones in the area.

Welcome to the nation's secret underground hospital. The facility 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. “Our facility sits 6 metres under the earth. This is the safest way of providing help to our wounded military personnel. It also ensures medical personnel protected,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a each day. Their conditions vary. 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 Russian FPV drones, which release explosives with lethal 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 conflict,” the surgeon explained.

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

During one day recently, a group of three soldiers walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, said an FPV blast had torn a minor wound in his limb. “War is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the Russians released a another grenade on him.” He continued: “Everything in the village is demolished. There are UAVs all around and bodies. Our side's and theirs.”

The soldier explained his squad spent 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. The only way to get to their position was by walking. All supplies arrived by drone: food and water. A week following he was injured, he traveled five kilometers (roughly three miles), requiring three hours, to where an military transport was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse gave him new non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone caused a minor injury in his leg.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he said. “I think I was fortunate to survive. My cousin has been lost. There are continuous detonations.” A builder working in a neighboring country, he noted he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a stained bandage and treated his recent injury from fragments. Covered in a thermal sheet, he used a cellphone to call his sister. “A piece of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to go back to my military group. Someone must protect our nation,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the back by a fragment of mortar.

Since 2022, Russia has repeatedly attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 medical personnel have been fatally attacked in almost 2,000 attacks. The underground facility is constructed from multiple steel bunkers, with timber beams, earth and sand placed above reaching ground level. It can withstand impacts from large-caliber artillery shells and even multiple eight-kilogram TNT charges dropped by drone.

The Ukrainian industrial group, which financed the construction, plans to build twenty units in total. A senior official of the nation's national security council and former military leader, the official, said they would be “critically essential for saving the survival of our military and supporting troops on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken since the enemy's military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, said some injured soldiers had to wait hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “We had a pair of critically ill patients who came at 3am. I had to perform a removal of both limbs on a patient. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “My career in medicine for two decades. One must concentrate,” he remarked.

Orderlies wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was parked under a bush. The patient and the two other military members were transferred to the city of Dnipro for further treatment. The underground hospital staff took a break. The hospital’s orange feline, the mascot, padded toward the doorway to await the incoming patients. “We are active around the clock,” the surgeon stated. “It doesn’t stop.”