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Scrubby foliage hide the entrance. One descending timber tunnel leads down to a well-illuminated reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, drugs and organized stacks of extra garments. Within a staff room with a washing machine and kettle, doctors monitor a screen. The screen reveals the movements of enemy surveillance UAVs as they zigzag in the air above.

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

This is Ukraine’s covert below-ground hospital. The facility began operations in August and is the second such installation, located 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 under the ground. This is the safest method of delivering care to our wounded military personnel. And it keeps medical personnel safe,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty patients a day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of Russian FPV aerial devices, which drop explosives with lethal precision. “90% of our patients are from FPVs. We see few gunshot wounds. This is an era of drones and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for injured troops in the eastern region.

During one afternoon last week, three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a minor wound in his leg. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians released a second explosive on him.” He continued: “Everything in the settlement is destroyed. There are UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his squad spent 43 days in a wooded zone close to the city, which Russia has been trying to seize since last year. The only way to get to their location was on foot. All supplies arrived by quadcopter: food and drinking water. Seven days after he was injured, he traveled 5km (about 3 miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medic assessed his physical condition. Following care, a medical attendant gave him fresh civilian clothes: a T-shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a FPV aerial device ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had left him with a head injury. “I was in a dugout. It suddenly became black. I lost sensation anything or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. We face ongoing detonations.” A construction worker employed in Lithuania, Filipchuk said he had returned to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff laid him on a bed, removed a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to call his sister. “A piece of artillery hit me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a several months. Subsequently, to go back to my unit. Someone must defend our country,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from four steel bunkers, with timber beams, soil and granular material placed above reaching the surface. It is designed to resist impacts from 152mm projectiles and even multiple eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which funded the building, intends to build twenty units in total. The head of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “critically essential for saving the survival of our military and supporting troops on the frontline.” The organization referred to the project as the “most ambitious and challenging” it had implemented since Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, said certain injured soldiers had to wait many hours or even days before they could be transported because of the threat of air assaults. “Our facility received two critically ill casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His tourniquet had been applied for so long there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants wheeled the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed under a shrub. The patient and the two other soldiers were taken to the city of Dnipro for further treatment. The subterranean hospital staff paused for rest. The facility's ginger cat, Vasilevs, padded up to the entrance to await the incoming patients. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”