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Scrubby trees conceal the entrance. One descending wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, drugs and neat piles of spare clothes. In a break area with a washing machine and hot water heater, physicians keep an eye on a screen. The screen reveals the movements of Russian spy drones as they zigzag in the sky above.

Medical staff at an underground medical center look at a screen displaying enemy kamikaze and reconnaissance drones in the region.

Welcome to Ukraine’s secret underground hospital. This center began operations in the eighth month and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres below the earth. This is the most secure method of delivering care to our injured soldiers. It also ensures medical personnel safe,” stated the facility's lead doctor, Maj the chief surgeon.

This medical station handles 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Others can walk. Almost all are the casualties of enemy FPV drones, which drop grenades with deadly precision. “90% of our cases are from first-person view drones. We see minimal gunshot wounds. It’s an era of drones and a different kind of war,” the doctor said.

Maj Oleksandr Holovashchenko at the underground installation for treating wounded troops in the eastern region.

On one day last week, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “Conflict is terrible. The guy beside me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a another grenade on him.” He continued: “All structures in the village is destroyed. There are drones everywhere and bodies. Ours 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. The only way to reach their location was by walking. All supplies arrived by drone: rations and drinking water. Seven days following he was hurt, he traveled five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his physical condition. After treatment, a nurse gave him new civilian clothes: a shirt and a pair of pale denim trousers.

The soldier, twenty-eight, said a FPV aerial device caused a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he explained. “I believe I was lucky to survive. My cousin has been killed. There are continuous explosions.” A builder employed in a neighboring country, Filipchuk noted he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, took off a stained bandage and treated his recent shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to call his sister. “A piece of artillery hit me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To get better. This may require a several months. After that, to return to my unit. Our forces has to defend our country,” he said.

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

Over the past years, enemy forces has consistently attacked hospitals, health facilities, maternity wards and ambulances. According to human rights groups, over two hundred health workers have been fatally attacked in almost 2,000 attacks. The underground facility is constructed from four reinforced shelters, with wooden supports, soil and sand laid on top reaching ground level. It can withstand direct hits from large-caliber projectiles and even three 8kg explosive devices released by aerial means.

The Ukrainian industrial group, which funded the construction, plans to erect 20 units in total. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, said they would be “critically essential for preserving the survival of our military and supporting troops on the frontline.” The organization described the initiative as the “largest-scale and challenging” it had undertaken after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained some wounded soldiers had to endure delays many hours or even days before they could be evacuated because of the danger of air assaults. “We had two severely injured casualties who came at the early hours. It was necessary to perform a double amputation on a patient. His tourniquet had been applied for so long there was no alternative.” How did he cope with severe surgeries? “My career in medicine for two decades. You have to concentrate,” he said.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. The patient and the two other military members were taken to the city of Dnipro for further treatment. The underground medical team paused for rest. The facility's ginger cat, Vasilevs, padded up to the entrance to greet the incoming patients. “We are open around the clock,” the surgeon said. “The work is continuous.”