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Scrubby trees hide the entrance. A sloping wooden tunnel descends to a brightly lit welcome zone. There is a operating ward, equipped with beds, cardiac monitors and breathing machines. Plus shelves full of medical equipment, drugs and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, doctors monitor a screen. It shows the movements of Russian spy drones as they weave in the sky above.

Medical personnel at an underground medical center observe a screen displaying Russian kamikaze and reconnaissance UAVs in the area.

Welcome to Ukraine’s secret below-ground hospital. The facility began operations in the eighth month and is the second such installation, situated in the eastern part of the country close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the ground. It’s the most secure method of providing help to our injured soldiers. And it keeps healthcare workers protected,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a day. Their conditions vary. Some have catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of Russian FPV aerial devices, which release grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter few gunshot wounds. It’s an era of drones and a new type of conflict,” the surgeon said.

Major the senior surgeon at the underground installation for treating injured troops in eastern Ukraine.

During one afternoon last week, a group of three soldiers limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a minor wound in his limb. “War is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He added: “Everything in the village is demolished. We see UAVs everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his unit spent over a month in a wooded zone close to 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. A week following he was hurt, he traveled 5km (about 3 miles), taking several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. After treatment, a nurse gave him new non-military attire: a shirt and a set of light-colored jeans.

The soldier, twenty-eight, said a first-person view drone ripped a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I think I was fortunate to survive. A relative has been killed. There are ongoing detonations.” A builder employed in Lithuania, Filipchuk said he had come back to his homeland and enlisted to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a bloody bandage and treated his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to ring his family member. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To recover. This may require a few months. After that, to return to my military group. Someone must defend our nation,” he said.

Medical staff treat the wounded soldier, who was hit in the dorsal area by a fragment of mortar.

Over the past years, Russia has consistently attacked medical centers, health facilities, maternity wards and ambulances. According to human rights groups, 261 health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, earth and sand placed above reaching ground level. It can withstand direct hits from 152mm projectiles and even three eight-kilogram explosive devices released by aerial means.

A major steel and mining company, which funded the construction, intends to erect twenty units in total. The head of the nation's national security council and former military leader, Rustem Umerov, said they would be “vitally important for saving the survival of our military and assisting defenders on the frontline.” The company described the project as the “largest-scale and demanding” it had implemented after the enemy's invasion.

An example of the facility's surgical rooms.

The surgeon, said certain injured soldiers had to endure delays many hours or even days before they could be evacuated because of the threat of aerial attacks. “We had a pair of severely injured casualties who came at the early hours. I had to carry out a removal of both limbs on one of them. His tourniquet had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “I’ve been healthcare for 20 years. One must concentrate,” he said.

Orderlies transported the soldier up the passage and into an ambulance. The transport was stationed beneath a shrub. The patient and the two other soldiers were taken to the city of a major city for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to await the incoming patients. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”