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Scrubby foliage conceal the entryway. One sloping timber tunnel leads down to a brightly lit welcome zone. There is a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, medications and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the air above.

Hospital staff at an underground hospital observe a screen showing Russian suicide and reconnaissance UAVs in the area.

Welcome to Ukraine’s secret underground hospital. This center began operations in August 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. “We are 6 metres under the ground. This is the safest way of providing help to our injured military personnel. And it keeps healthcare workers safe,” stated the facility's lead doctor, Maj the chief surgeon.

The stabilisation point treats 30-40 patients a day. Their conditions vary. Some have catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter minimal bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for injured troops in eastern Ukraine.

During one day last week, three soldiers limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had torn a minor wound in his leg. “Conflict is horrific. The guy beside me, Vasyl, was killed,” he stated. “He fell down. Then the Russians released a second explosive on him.” He continued: “Everything in the settlement is destroyed. There are UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi explained his unit spent over a month in a forest area near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies arrived by quadcopter: food and drinking water. Seven days following he was hurt, he traveled five kilometers (about 3 miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his physical condition. Following care, a nurse gave him fresh civilian clothes: a shirt and a set of pale denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I think I was fortunate to survive. My cousin has been killed. There are continuous explosions.” A builder employed in Lithuania, Filipchuk said he had returned to Ukraine and enlisted to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors laid him on a bed, took off a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of artillery struck me. It was a ricochet. I’m OK,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to go back to my military group. Someone has to defend our nation,” he affirmed.

Medical staff treat the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Over the past years, Russia has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in almost two thousand assaults. The underground facility is constructed from four steel bunkers, with timber beams, earth and sand laid on top reaching ground level. It can withstand direct hits from 152mm artillery shells and even multiple eight-kilogram TNT charges released by drone.

The Ukrainian industrial group, which funded the construction, plans to build twenty facilities in all. The head of the nation's national security council and ex- defence minister, Rustem Umerov, declared they would be “critically essential for preserving the survival of our military and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and demanding” it had undertaken since the enemy's military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained certain wounded soldiers had to wait many hours or even days before they could be transported due to the threat of air assaults. “We had two severely injured patients who arrived at the early hours. It was necessary to perform a double amputation on a patient. His tourniquet had been on for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed under a bush. The patient and the two other soldiers were transferred to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The facility's orange feline, the mascot, walked up to the entrance to greet the next arrivals. “Our facility operates active around the clock,” the surgeon stated. “It doesn’t stop.”