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Scrubby foliage conceal the entrance. A sloping wooden passageway descends to a brightly lit reception area. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus shelves full of healthcare supplies, medications and organized stacks of extra garments. Within 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 surveillance UAVs as they zigzag in the air above.

Medical personnel at an subterranean medical center observe a screen showing Russian kamikaze and surveillance drones in the region.

Welcome to the nation's secret below-ground hospital. This center opened in the eighth month and is the second such installation, situated in the eastern part of the country close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the ground. It’s the most secure method of delivering care to our wounded soldiers. It also ensures medical personnel protected,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point treats thirty to forty patients a day. Cases differ widely. Some have catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an era of drones and a new type of war,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded troops in the eastern region.

During one afternoon last week, a group of three military members walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a small hole in his limb. “War is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces released a another explosive on him.” He added: “All structures in the settlement is destroyed. There are UAVs all around and casualties. Our side's and theirs.”

The soldier explained his unit endured 43 days in a forest area near the city, which Russia has been trying to seize for many months. Sole access to get to their location was on foot. Necessary provisions came by drone: rations and water. Seven days following he was injured, he walked 5km (about 3 miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. Following care, a nurse gave him new non-military attire: a T-shirt and a set of pale jeans.

The soldier, 28, stated a FPV drone ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. A relative has been killed. There are continuous detonations.” A builder employed in a neighboring country, he noted he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a medical cot, removed a stained dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A fragment of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a several months. After that, to go back to my military group. Someone must defend our nation,” he said.

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

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in almost two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with wooden supports, earth and granular material placed above up to the surface. It can withstand impacts from large-caliber projectiles and even multiple 8kg TNT charges dropped by aerial means.

A major steel and mining company, which funded the building, intends to build 20 facilities in all. The head of Ukraine’s national security council and former military leader, Rustem Umerov, declared they would be “vitally important for preserving the lives of our armed forces and assisting defenders on the battlefront.” The company referred to the project as the “largest-scale and challenging” it had undertaken since Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, said some injured soldiers had to endure delays many hours or even multiple days before they could be transported due to the threat of air assaults. “We had two critically ill patients who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no other option.” How did he cope with severe operations? “I’ve been healthcare for two decades. One must concentrate,” he remarked.

Orderlies transported Mykolaichuk up the passage and into an emergency vehicle. The transport was parked beneath a bush. The patient and the other soldiers were taken to the city of a major city for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded toward the doorway to greet the incoming patients. “We are active 24 hours a day,” Holovashchenko said. “The work is continuous.”