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Scrubby foliage hide the entrance. One sloping wooden passageway descends to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And cabinets stocked of healthcare supplies, medications and organized stacks of extra garments. In a staff room with a laundry appliance and hot water heater, physicians monitor a screen. It shows the movements of enemy spy drones as they weave in the air above.

Medical staff at an underground medical center look at a monitor displaying Russian suicide and reconnaissance UAVs in the area.

This is the nation's covert underground hospital. The facility began operations in August and is the second of its kind, located in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the safest way of delivering care to our wounded military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release grenades with lethal accuracy. “90% of our cases are from FPVs. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a new type of war,” the doctor explained.

Major the senior surgeon at the subterranean facility for treating injured troops in eastern Ukraine.

During one day recently, three soldiers limped into the hospital. The least severely hurt, 28-year-old one soldier, reported an FPV explosion had ripped a small hole in his leg. “War is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the Russians dropped a second explosive on him.” He continued: “All structures in the settlement is demolished. There are UAVs all around and casualties. Ours and theirs.”

The soldier said his squad endured 43 days in a forest area near the city, which Russia has been trying to seize since last year. Sole access to reach their position was by walking. All supplies arrived by quadcopter: food and water. A week after he was hurt, he walked 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly became black. I lost sensation anything or any sound,” he explained. “I think I was lucky to remain alive. My cousin has been lost. There are ongoing detonations.” A builder employed in a neighboring country, Filipchuk noted he had returned to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff placed him on a medical cot, removed a stained bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his family member. “A fragment of mortar hit me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. This may require a few months. Subsequently, to return to my military group. Our forces has to defend our country,” he affirmed.

Doctors care for the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly attacked medical centers, clinics, obstetric units and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in nearly two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with timber beams, earth and sand placed above up to the surface. It can withstand direct hits from 152mm projectiles and even multiple eight-kilogram TNT charges dropped by drone.

The Ukrainian industrial group, which financed the construction, plans to erect twenty units in total. A senior official of the nation's security agency and former military leader, the official, said they would be “vitally essential for saving the survival of our armed forces and assisting troops on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had undertaken since Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, said some injured personnel had to endure delays hours or even multiple days before they could be evacuated due to the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to carry out a double amputation on one of them. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with severe operations? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk up the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the two other military members were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's ginger cat, the mascot, walked toward the entrance to greet the incoming patients. “Our facility operates open around the clock,” Holovashchenko stated. “The work is continuous.”