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Sparse trees conceal the entrance. One descending timber tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. Plus shelves stocked of healthcare supplies, medications and neat piles of extra garments. In a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground medical center observe a screen displaying Russian suicide and surveillance drones in the area.

Welcome to the nation's covert underground hospital. The facility began operations in the eighth month and is the second of its kind, situated in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. It’s the most secure way of delivering care to our wounded military personnel. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Maj the chief surgeon.

The stabilisation point treats 30-40 casualties a each day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop grenades with lethal precision. “90% of our cases are from first-person view drones. We encounter few gunshot wounds. This is an era of drones and a different kind of conflict,” the doctor said.

Maj the senior surgeon at the underground installation for caring for wounded soldiers in eastern Ukraine.

On one day last week, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had ripped a small hole in his leg. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He collapsed. Then the enemy forces released a second explosive on him.” He continued: “All structures in the village is demolished. There are UAVs everywhere and bodies. Ours and the enemy's.”

Dvorskyi said his squad spent over a month in a forest area near the city, which Russia has been trying to seize since last year. The only way to reach their location was by walking. All supplies arrived by quadcopter: food and water. A week after he was hurt, he traveled five kilometers (about 3 miles), taking several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his physical condition. After treatment, a medical attendant gave him new non-military attire: a T-shirt and a set of pale denim trousers.

The soldier, 28, stated a FPV drone ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to survive. A relative has been lost. We face continuous detonations.” A builder working in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to serve days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a bed, took off a stained dressing and treated his recent injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to call his family member. “A piece of artillery struck me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my unit. Someone has to defend our country,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Over the past years, enemy forces has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. According to human rights groups, 261 health workers have been fatally attacked in nearly 2,000 assaults. The underground facility is constructed from four reinforced shelters, with timber beams, soil and granular material placed above up to the surface. It is designed to resist impacts from large-caliber artillery shells and even three eight-kilogram TNT charges released by drone.

The Ukrainian steel and mining company, which funded the building, intends to build 20 facilities in all. The head of the nation's national security council and former defence minister, the official, said they would be “vitally essential for saving the lives of our military and supporting troops on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented since the enemy's invasion.

An example of the facility's surgical rooms.

Holovashchenko, said some injured personnel had to wait many hours or even days before they could be evacuated because of the danger of aerial attacks. “Our facility received two severely injured casualties 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 so long there was no other option.” What is his method with severe operations? “My career in healthcare for 20 years. You have to focus,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The transport was stationed under a bush. The patient and the other military members were taken to the city of a major city for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, the mascot, padded toward the entrance to greet the next arrivals. “Our facility operates open around the clock,” the surgeon said. “It doesn’t stop.”