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Scrubby foliage conceal the entrance. A sloping wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and breathing machines. And cabinets stocked of medical equipment, medications and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, physicians monitor a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Medical personnel at an subterranean hospital observe a screen displaying Russian suicide and reconnaissance drones in the area.

This is the nation's secret underground hospital. The facility opened in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “We are six meters below the earth. It’s the safest way of delivering care to our wounded military personnel. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Their conditions vary. Some have devastating leg injuries necessitating surgical removal, or serious abdominal injuries. Others can walk. Almost all are the victims of Russian first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our patients are from FPVs. We see few gunshot wounds. This is an age of unmanned aircraft and a new type of war,” the surgeon explained.

Major the senior surgeon at the underground facility for caring for injured soldiers in eastern Ukraine.

On one afternoon recently, three military members walked with difficulty into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his leg. “War is terrible. The guy beside me, a fellow soldier, was killed,” he stated. “He collapsed. Then the enemy forces released a another grenade on him.” He added: “Everything in the village is destroyed. We see UAVs all around and bodies. Our side's and theirs.”

The soldier explained his squad spent 43 days in a wooded zone near the city, which Russia has been trying to seize for many months. The only way to get to their position was on foot. All supplies came by quadcopter: rations and water. A week following he was injured, he walked 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his physical condition. After treatment, a nurse provided him with new non-military attire: a shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, stated a first-person view aerial device caused a minor injury in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “My position was in a dugout. Suddenly it became black. I couldn’t feel anything or any sound,” he said. “I think I was lucky to survive. A relative has been lost. There are ongoing explosions.” A builder working in a neighboring country, he noted he had come back to his homeland and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as medical staff laid him on a medical cot, took off a stained dressing and treated his recent injury from fragments. Covered in a foil blanket, he used a mobile phone to ring his sister. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. That will take a few months. After that, to go back to my unit. Someone has to defend our country,” he said.

Medical staff care for the wounded soldier, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has repeatedly targeted hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred health workers have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and sand placed above reaching the surface. It can withstand direct hits from 152mm artillery shells and even multiple eight-kilogram explosive devices dropped by drone.

A major steel and mining company, which financed the construction, plans to erect twenty facilities in all. The head of Ukraine’s national security council and former defence minister, Rustem Umerov, declared they would be “vitally important for preserving the survival of our armed forces and assisting troops on the battlefront.” The company described the initiative as the “largest-scale and challenging” it had implemented since the enemy's invasion.

One of the centre’s surgical rooms.

Holovashchenko, explained some injured personnel had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had two critically ill casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been applied for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for two decades. One must focus,” he remarked.

Orderlies transported Mykolaichuk up the passage and into an emergency vehicle. The transport was stationed under a shrub. The patient and the other soldiers were transferred to the urban center of Dnipro for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded up to the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “The work is continuous.”