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Sparse foliage hide the entrance. A sloping timber tunnel descends to a well-illuminated reception area. There is a operating ward, equipped with beds, heart rate sensors and ventilators. Plus shelves stocked of healthcare supplies, medications and organized stacks of extra garments. Within a staff room with a washing machine and kettle, doctors keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center observe a monitor showing Russian suicide and reconnaissance drones in the region.

This is Ukraine’s secret underground hospital. The facility began operations in August and is the second such installation, situated in eastern Ukraine close to 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 delivering care to our wounded military personnel. It also ensures medical personnel protected,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a each day. Cases differ widely. Some have catastrophic leg injuries requiring surgical removal, or severe abdominal injuries. Others can move on their own. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which release grenades with deadly accuracy. “Ninety per cent of our patients are from FPVs. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured troops in the eastern region.

On one afternoon recently, three military members limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone blast had torn a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was killed,” he said. “He fell down. Then the Russians released a second grenade on him.” He added: “All structures in the village is destroyed. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi said his squad endured 43 days in a forest area near Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their location was by walking. Necessary provisions arrived by quadcopter: rations and drinking water. A week following he was hurt, he walked 5km (roughly three miles), taking three hours, to where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view drone caused a small hole in his leg.

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I think I was fortunate to survive. A relative has been killed. We face ongoing explosions.” A construction worker working in a neighboring country, Filipchuk said he had returned to his homeland and volunteered to fight days before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as medical staff laid him on a medical cot, removed a bloody bandage and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A piece of mortar struck me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. After that, to go back to my unit. Someone must protect our country,” he said.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Since 2022, Russia has consistently targeted medical centers, clinics, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been killed in almost two thousand attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, earth and sand placed above reaching the surface. It can withstand impacts from 152mm projectiles and even multiple 8kg explosive devices dropped by drone.

The Ukrainian industrial group, which financed the construction, intends to build 20 units in all. The head of Ukraine’s national security council and ex- military leader, Rustem Umerov, declared they would be “critically important for preserving the lives of our armed forces and assisting troops on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had implemented since Russia’s military offensive.

An example of the facility's operating theatres.

The surgeon, explained certain wounded personnel had to wait many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received a pair of critically ill casualties who arrived at 3am. I had to perform a double amputation on one of them. The soldier's tourniquet had been on for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “My career in healthcare for two decades. One must concentrate,” he said.

Medical assistants transported the soldier through the passage and into an ambulance. The transport was stationed beneath a shrub. The patient and the two other soldiers were taken to the urban center of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked up to the doorway to await the incoming patients. “Our facility operates open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”