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Scrubby foliage hide the entryway. A sloping timber tunnel descends to a brightly lit reception area. There is a operating ward, equipped with gurneys, heart rate sensors and breathing machines. Plus cabinets stocked of healthcare supplies, drugs and organized stacks of extra garments. In a break area with a washing machine and hot water heater, doctors monitor a display. It shows the movements of Russian spy drones as they weave in the sky above.

Medical staff at an subterranean medical center look at a monitor showing Russian kamikaze and surveillance drones in the region.

This is the nation's covert underground hospital. This center opened in August and is the second of its kind, situated in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. It’s the most secure method of delivering care to our wounded soldiers. It also ensures medical personnel safe,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious stomach wounds. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which release explosives with deadly precision. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. It’s an era of drones and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in eastern Ukraine.

On one afternoon last week, three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a second grenade on him.” He continued: “Everything in the village is demolished. There are drones all around and casualties. Our side's and the enemy's.”

Dvorskyi said his unit spent 43 days in a forest area near the city, which Russia has been trying to seize for many months. The only way to reach their location was on foot. All supplies arrived by drone: rations and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), requiring three hours, to a point where an military transport was able to pick him up. Upon arrival, a medical staff checked his vital signs. After treatment, a medical attendant gave him new civilian clothes: a T-shirt and a pair of light-colored denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was lucky to remain alive. My cousin has been lost. There are ongoing explosions.” A construction worker working in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff laid him on a medical cot, removed a stained dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he used a cellphone to call his sister. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my military group. Our forces must defend our nation,” he affirmed.

Doctors care for Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Since 2022, enemy forces has consistently targeted hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been fatally attacked in almost two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, soil and granular material placed above reaching ground level. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 facilities in total. A senior official of Ukraine’s security agency and former military leader, Rustem Umerov, said they would be “vitally important for preserving the lives of our military and supporting troops on the frontline.” The company described the initiative as the “largest-scale and challenging” it had undertaken after the enemy's military offensive.

An example of the centre’s surgical rooms.

The surgeon, explained some injured personnel had to endure delays many hours or even days before they could be evacuated because of the threat of aerial attacks. “We had two critically ill casualties who came at 3am. I had to perform a double amputation on one of them. The soldier's bleeding control device had been on for such an extended period there was no other option.” What is his method with severe surgeries? “I’ve been medicine for two decades. One must focus,” he remarked.

Medical assistants transported the soldier up the passage and into an ambulance. The transport was parked beneath a bush. The patient and the other soldiers were taken to the urban center of a major city for further treatment. The subterranean medical team took a break. The facility's ginger cat, the mascot, walked up to the entrance to await the next arrivals. “We are open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”