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Scrubby trees conceal the entryway. One descending wooden passageway leads down to a well-illuminated welcome zone. There is a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. Within a staff room with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the movements of Russian surveillance UAVs as they weave in the air above.

Hospital staff at an subterranean medical center look at a monitor displaying enemy suicide and reconnaissance drones in the region.

This is Ukraine’s covert underground hospital. This center opened in the eighth month and is the second of its kind, situated in the eastern part of the country close to the combat zone and the city of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the ground. It’s the most secure way of delivering care to our injured military personnel. And it keeps healthcare workers safe,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of Russian FPV drones, which drop grenades with deadly accuracy. “Ninety per cent of our patients are from FPVs. We encounter few bullet injuries. This is an era of drones and a new type of war,” the doctor said.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

On one afternoon recently, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his leg. “War is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Subsequently the enemy forces released a another grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs everywhere and casualties. Ours and theirs.”

The soldier said his squad spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to reach their position was on foot. Necessary provisions arrived by quadcopter: food and drinking water. A week after he was injured, he walked five kilometers (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his physical condition. Following care, a nurse provided him with new civilian clothes: a shirt and a pair of light-colored jeans.

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

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I think I was lucky to remain alive. A relative has been lost. We face continuous detonations.” A construction worker employed in a neighboring country, Filipchuk said he had returned to his homeland and volunteered to serve shortly before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff laid him on a medical cot, took off a bloody dressing and cleaned his recent shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of artillery hit me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To get better. This may require a several months. After that, to go back to my unit. Someone has to defend our country,” he said.

Doctors care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. According to international monitors, over two hundred health workers have been killed in nearly two thousand assaults. This subterranean hospital is built from four steel bunkers, with timber beams, earth and sand laid on top up to the surface. It can withstand impacts from large-caliber projectiles and even multiple 8kg explosive devices released by aerial means.

A major industrial group, which financed the building, intends to build twenty units in total. A senior official of Ukraine’s national security council and ex- military leader, the official, declared they would be “critically important for preserving the lives of our armed forces and assisting troops on the battlefront.” The organization described the initiative as the “largest-scale and demanding” it had implemented since Russia’s invasion.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain injured personnel had to wait many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had two severely injured patients who came at 3am. I had to perform a double amputation on one of them. The soldier's tourniquet had been on for such an extended period there was no other option.” What is his method with traumatic surgeries? “My career in healthcare for two decades. One must focus,” he said.

Medical assistants transported Mykolaichuk up the passage and into an ambulance. The transport was parked beneath a bush. He and the two other soldiers were taken 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 entrance to greet the next arrivals. “We are open around the clock,” Holovashchenko said. “The work is continuous.”