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Scrubby foliage hide the entrance. One sloping timber passageway leads down to a well-illuminated reception area. There is a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a washing machine and hot water heater, doctors monitor a display. The screen reveals the movements of Russian spy drones as they zigzag in the sky above.

Hospital personnel at an subterranean hospital look at a screen displaying enemy kamikaze and surveillance UAVs in the region.

This is the nation's covert underground hospital. The facility began operations in the eighth month and is the second of its kind, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters below the ground. It’s the safest way of providing help to our wounded soldiers. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring surgical removal, or severe abdominal injuries. Others can walk. Almost all are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We see few bullet injuries. This is an age of drones and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for treating wounded troops in the eastern region.

During one day last week, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone explosion had torn a small hole in his limb. “Conflict is horrific. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a second grenade on him.” He continued: “All structures in the settlement is destroyed. We see drones everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his unit spent 43 days in a forest area near Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their location was by walking. All supplies came by quadcopter: rations and drinking water. Seven days following he was injured, he traveled 5km (roughly three miles), taking three hours, to a point where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, said a FPV aerial device caused a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. There are ongoing detonations.” A builder working in a neighboring country, Filipchuk noted he had come back to Ukraine and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a medical cot, removed a bloody dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A fragment of artillery hit me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. That will take a few months. Subsequently, to go back to my unit. Our forces must defend our nation,” he affirmed.

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

Over the past years, Russia has consistently targeted medical centers, clinics, obstetric units and ambulances. According to human rights groups, 261 health workers have been fatally attacked in nearly two thousand attacks. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and sand laid on top reaching the surface. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges released by drone.

A major steel and mining company, which financed the construction, intends to build 20 units in all. A senior official of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for saving the lives of our armed forces and supporting defenders on the frontline.” The organization described the initiative as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

One of the facility's operating theatres.

The surgeon, said certain injured personnel had to wait hours or even days before they could be transported due to the threat of air assaults. “Our facility received two critically ill patients who arrived at the early hours. It was necessary to perform a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” How did he cope with severe operations? “My career in medicine for 20 years. One must focus,” he said.

Orderlies transported Mykolaichuk through the passage and into an emergency vehicle. The transport was parked under a bush. The patient and the other soldiers were taken to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, walked toward the doorway to await the next arrivals. “We are open 24 hours a day,” Holovashchenko said. “The work is continuous.”