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Sparse foliage hide the entrance. One sloping timber passageway descends to a brightly lit welcome zone. There is a surgery unit, equipped with beds, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Medical staff at an underground hospital look at a screen showing enemy suicide and reconnaissance drones in the area.

Welcome to Ukraine’s covert below-ground hospital. This center opened in August and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in the Donetsk region. “We are six meters below the ground. It’s the most secure way of providing help to our wounded soldiers. And it keeps healthcare workers protected,” stated the clinic’s lead doctor, Major the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from devastating limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) drones, which release explosives with deadly accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean installation for treating injured troops in the eastern region.

During one day last week, three soldiers limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a minor wound in his limb. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces dropped a second explosive on him.” He added: “All structures in the settlement is destroyed. We see UAVs all around and bodies. Our side's and theirs.”

Dvorskyi explained his squad endured over a month in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their position was by walking. All supplies came by quadcopter: food and drinking water. Seven days after he was injured, he walked five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with fresh civilian clothes: a shirt and a set of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view drone caused a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he said. “I think I was fortunate to remain alive. A relative has been lost. We face continuous explosions.” A builder employed in a neighboring country, he said he had come back to Ukraine and volunteered to serve days before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as doctors laid him on a bed, took off a stained dressing and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his sister. “A piece of artillery hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. That will take a several months. Subsequently, to go back to my military group. Our forces has to protect our country,” he affirmed.

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

Since 2022, enemy forces has repeatedly targeted hospitals, health facilities, maternity wards and ambulances. Per human rights groups, 261 health workers have been fatally attacked in almost two thousand attacks. This subterranean hospital is built from four reinforced shelters, with wooden supports, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even three eight-kilogram explosive devices dropped by drone.

The Ukrainian steel and mining company, which financed the construction, plans to build twenty units in all. The head of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “critically important for preserving the lives of our armed forces and supporting defenders on the frontline.” The company described the project as the “most ambitious and demanding” it had undertaken after Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained certain injured personnel had to wait hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received two severely injured casualties who came at 3am. It was necessary to carry out a double amputation on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with severe operations? “My career in medicine for 20 years. You have to focus,” he said.

Medical assistants transported the soldier up the tunnel and into an ambulance. The vehicle was stationed beneath a bush. He and the two other military members were taken to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's ginger cat, the mascot, walked up to the entrance to await the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”