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Sparse trees conceal the entrance. A descending timber passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. And shelves full of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Medical personnel at an underground hospital look at a screen showing Russian suicide and reconnaissance drones in the region.

This is Ukraine’s secret underground hospital. This center opened in August and is the second such installation, located in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. This is the safest method of providing help to our injured military personnel. And it keeps healthcare workers protected,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty casualties a day. Their conditions vary. Some have devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of Russian FPV aerial devices, which release explosives with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We see minimal bullet injuries. This is an age 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.

On one afternoon recently, a group of three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a minor wound in his leg. “Conflict is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He collapsed. Then the enemy forces dropped a another explosive on him.” He added: “Everything in the village is demolished. We see drones everywhere and casualties. Ours and the enemy's.”

The soldier explained his unit spent over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their position was on foot. All supplies arrived by drone: food and water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to where an military transport was able to pick him up. At the clinic, a medical staff assessed his physical condition. Following care, a nurse gave him new civilian clothes: a shirt and a set of light-colored denim trousers.

Artem Dvorskiy, 28, stated a first-person view aerial device ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. There are ongoing detonations.” A construction worker employed in a neighboring country, he said he had come back to Ukraine and volunteered to fight days before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, took off a bloody dressing and treated his recent injury from fragments. Covered in a foil blanket, he borrowed a mobile phone to call his sister. “A fragment of artillery hit me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. This may require a few months. After that, to return to my military group. Someone has to defend our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Since 2022, Russia has consistently targeted hospitals, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred health workers have been killed in almost 2,000 assaults. The underground facility is built from four steel bunkers, with timber beams, earth and sand placed above reaching ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg explosive devices dropped by aerial means.

A major steel and mining company, which financed the construction, plans to erect 20 units in total. A senior official of Ukraine’s national security council and ex- defence minister, the official, declared they would be “critically important for preserving the survival of our armed forces and supporting troops on the frontline.” The organization referred to the initiative as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained some wounded soldiers had to endure delays hours or even multiple days before they could be transported because of the threat of aerial attacks. “Our facility received a pair of critically ill patients who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Orderlies wheeled the soldier up the passage and into an ambulance. The vehicle was parked under a shrub. He and the other soldiers 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, walked toward the entrance to await the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”