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Sparse trees conceal the entryway. A descending timber tunnel leads down to a brightly lit welcome zone. Inside lies 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 staff room with a washing machine and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Medical personnel at an subterranean medical center look at a screen showing Russian suicide and reconnaissance drones in the region.

This is Ukraine’s secret underground hospital. This center began operations in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the earth. It’s the most secure method of delivering care to our injured military personnel. It also ensures healthcare workers protected,” stated the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our patients are from FPVs. We see minimal gunshot wounds. This is an age of drones and a different kind of war,” the doctor explained.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in eastern Ukraine.

During one day recently, a group of three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a small hole in his leg. “Conflict is terrible. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He continued: “All structures in the village is demolished. There are drones all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit endured 43 days in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. All supplies came by drone: rations and drinking water. A week following he was injured, he walked five kilometers (about 3 miles), taking 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 fresh non-military attire: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device ripped a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I think I was fortunate to remain alive. My cousin has been killed. There are ongoing explosions.” A construction worker employed in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to serve days before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the back. He expressed pain as medical staff laid him on a bed, took off a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. Subsequently, to go back to my military group. Our forces has to protect our country,” he said.

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

Since 2022, Russia has consistently attacked medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is built from multiple steel bunkers, with timber beams, soil and sand laid on top reaching the surface. It can withstand impacts from large-caliber projectiles and even three eight-kilogram explosive devices released by aerial means.

A major industrial group, which funded the building, intends to build 20 facilities in all. The head of Ukraine’s security agency and ex- military leader, the official, said they would be “vitally essential for preserving the survival of our military and supporting troops on the battlefront.” The organization referred to the initiative as the “largest-scale and challenging” it had undertaken after the enemy's invasion.

An example of the centre’s surgical rooms.

Holovashchenko, said some injured personnel had to wait many hours or even days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of severely injured casualties who came at the early hours. I had to perform a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with severe surgeries? “My career in medicine for two decades. One must focus,” he said.

Orderlies wheeled Mykolaichuk up the passage and into an ambulance. The transport was parked under a shrub. He and the other soldiers were transferred to the urban center of a major city for further treatment. The underground hospital staff took a break. The hospital’s ginger cat, the mascot, padded toward the doorway to await the incoming patients. “We are open 24 hours a day,” the surgeon said. “It doesn’t stop.”