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Scrubby foliage hide the entryway. One sloping timber passageway leads down to a well-illuminated reception area. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, drugs and neat piles of extra garments. In a break area with a washing machine and hot water heater, doctors keep an eye on a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Hospital personnel at an underground medical center observe a screen displaying enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s covert below-ground hospital. The facility opened in the eighth month and is the second such installation, located 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 earth. This is the safest method of delivering care to our wounded soldiers. It also ensures healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Their conditions vary. Some have devastating limb trauma requiring amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which drop grenades with lethal precision. “Ninety per cent of our patients are from FPVs. We see few gunshot wounds. It’s an age of drones and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating injured troops in eastern Ukraine.

During one afternoon last week, three military members limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a small hole in his limb. “Conflict is terrible. My comrade beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces dropped a another grenade on him.” He continued: “Everything in the village is destroyed. We see UAVs all around and bodies. Our side's and theirs.”

The soldier said his unit endured over a month in a wooded zone near the city, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. Necessary provisions arrived by quadcopter: rations and water. A week after he was hurt, he traveled 5km (about 3 miles), taking three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked 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, stated a FPV drone caused a minor injury in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. We face continuous explosions.” A construction worker employed in a neighboring country, he said he had returned to his homeland and volunteered to serve shortly before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as doctors laid him on a bed, took off a bloody dressing and cleaned his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to call his family member. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To get better. This may require a several months. Subsequently, to return to my unit. Our forces has to protect our country,” he said.

Doctors treat the wounded soldier, who was injured in the back by a piece of mortar.

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. Per human rights groups, over two hundred health workers have been fatally attacked in almost 2,000 attacks. The underground facility is built from four reinforced shelters, with wooden supports, earth and sand placed above up to the surface. It is designed to resist impacts from 152mm artillery shells and even multiple eight-kilogram TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, intends to build 20 units in total. A senior official of the nation's security agency and ex- defence minister, the official, said they would be “vitally important for preserving the lives of our armed forces and assisting troops on the frontline.” The organization described the initiative as the “largest-scale and challenging” it had undertaken since the enemy's invasion.

An example of the centre’s operating theatres.

Holovashchenko, said some wounded personnel had to wait many hours or even multiple days before they could be evacuated due to the threat of air assaults. “Our facility received two severely injured patients who arrived at the early hours. I had to carry out a double amputation on one of them. The soldier's bleeding control device had been on for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been medicine for 20 years. You have to concentrate,” he said.

Medical assistants transported the soldier through the passage and into an emergency vehicle. The vehicle was parked under a shrub. He and the other soldiers were transferred to the urban center of a major city for further treatment. The underground hospital staff took a break. The hospital’s orange feline, the mascot, padded up to the doorway to greet the next arrivals. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”