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Scrubby trees hide the entryway. One sloping timber tunnel leads down to a brightly lit welcome zone. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the movements of Russian spy drones as they weave in the air above.

Medical staff at an underground hospital observe a monitor displaying Russian kamikaze and surveillance drones in the area.

Welcome to Ukraine’s covert below-ground hospital. The facility opened in August 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. “We are six meters under the ground. It’s the most secure way of providing help to our injured soldiers. And it keeps healthcare workers safe,” said the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from devastating limb trauma requiring surgical removal, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) aerial devices, which drop grenades with lethal precision. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground facility for caring for wounded troops in the eastern region.

During one day recently, three military members limped into the hospital. The least severely hurt, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his leg. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a another explosive on him.” He added: “All structures in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his squad spent over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to reach their location was on foot. Necessary provisions arrived by drone: food and drinking water. A week following he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his physical condition. Following care, a nurse provided him with fresh non-military attire: a shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, stated a FPV aerial device ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had left him with a head injury. “My position was in a trench shelter. It suddenly became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous explosions.” A builder employed in a neighboring country, he said he had returned to his homeland and volunteered to fight days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as medical staff placed him on a bed, took off a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to call his sister. “A piece of mortar hit me. It was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to return to my unit. Our forces must protect our country,” he said.

Medical staff treat the wounded soldier, who was injured in the dorsal area by a piece of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. Per human rights groups, 261 health workers have been killed in nearly 2,000 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 152mm projectiles and even three 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which financed the construction, intends to build 20 units in total. A senior official of the nation's national security council and former defence minister, the official, declared they would be “vitally essential for preserving the survival of our military and supporting troops on the battlefront.” The organization described the initiative as the “largest-scale and challenging” it had implemented since Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, said some injured personnel had to endure delays many hours or even days before they could be transported because of the threat of aerial attacks. “We had a pair of critically ill casualties who came at the early hours. It was necessary to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no other option.” What is his method with severe surgeries? “I’ve been healthcare for 20 years. One must concentrate,” he said.

Orderlies wheeled the soldier up the passage and into an ambulance. The vehicle was stationed under a bush. The patient and the other military members were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s orange feline, Vasilevs, walked up to the doorway to await the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”