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Scrubby trees conceal the entryway. One sloping wooden passageway descends to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. And shelves full of medical equipment, drugs and organized stacks of spare clothes. In a staff room with a laundry appliance and kettle, doctors monitor a display. It shows the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Medical personnel at an underground hospital look at a monitor displaying Russian kamikaze and reconnaissance drones in the region.

Welcome to the nation's covert underground hospital. The facility opened in the eighth month and is the second of its kind, situated in eastern Ukraine not far from the frontline and the city of Pokrovsk in the Donetsk region. “We are 6 metres under the ground. This is the safest way of delivering care to our wounded soldiers. And it keeps healthcare workers safe,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy FPV drones, which release explosives with deadly precision. “90% of our patients are from FPVs. We encounter few bullet injuries. This is an era of drones and a new type of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating injured troops in eastern Ukraine.

During one afternoon last week, a group of three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the Russians dropped a another grenade on him.” He continued: “All structures in the settlement is demolished. We see UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi said his unit endured 43 days in a forest area near Pokrovsk, which Russia has been trying to seize for many months. The only way to get to their location was on foot. Necessary provisions came by drone: rations and drinking water. A week after he was injured, he walked 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant gave him fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, said a FPV aerial device ripped a small hole in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or hear anything,” he explained. “I think I was lucky to remain alive. My cousin has been lost. There are continuous detonations.” A builder working in Lithuania, he noted he had returned to his homeland and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a bed, removed a bloody dressing and cleaned his recent injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. Subsequently, to return to my unit. Our forces has to defend our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. According to international monitors, over two hundred medical personnel have been killed in nearly two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, soil and sand laid on top up to the surface. It is designed to resist impacts from large-caliber projectiles and even three eight-kilogram TNT charges released by aerial means.

A major steel and mining company, which financed the building, intends to erect 20 units in all. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, declared they would be “critically important for preserving the lives of our armed forces and assisting defenders on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained certain wounded soldiers had to wait hours or even days before they could be transported due to the danger of air assaults. “Our facility received a pair of critically ill patients who came at the early hours. I had to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been on for such an extended period there was no alternative.” How did he cope with severe operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The vehicle was parked under a shrub. He and the other military members were transferred to the urban center of Dnipro for additional medical care. The underground medical team took a break. The hospital’s orange feline, Vasilevs, walked toward the entrance to await the incoming patients. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”