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Scrubby trees hide the entrance. One descending timber passageway descends to a well-illuminated welcome zone. Inside lies a surgery unit, equipped with gurneys, heart rate sensors and breathing machines. Plus cabinets stocked of medical equipment, medications and neat piles of extra garments. In a staff room with a laundry appliance and kettle, physicians keep an eye on a display. It shows the flight patterns of enemy surveillance UAVs as they weave in the air above.

Hospital personnel at an underground medical center observe a screen displaying Russian suicide and reconnaissance UAVs in the region.

This is the nation's covert below-ground hospital. The facility began operations in August and is the second of its kind, situated in the eastern part of the country close to the combat zone and the city of Pokrovsk in the Donetsk region. “We are six meters under the earth. This is the safest method of delivering care to our wounded military personnel. It also ensures medical personnel protected,” stated the clinic’s surgeon, Maj the chief surgeon.

This medical station handles 30-40 patients a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which release explosives with lethal accuracy. “90% of our patients are from FPVs. We encounter minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the doctor explained.

Maj the senior surgeon at the subterranean installation for caring for wounded soldiers in the eastern region.

On one afternoon last week, three military members limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a second explosive on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and bodies. Ours and theirs.”

The soldier said his squad spent over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. All supplies arrived by quadcopter: rations and water. Seven days after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored jeans.

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

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a trench shelter. It suddenly became black. I lost sensation any feeling or any sound,” he explained. “I think I was lucky to remain alive. My cousin has been killed. We face continuous explosions.” A builder employed in Lithuania, Filipchuk said he had come back to Ukraine and enlisted to serve shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors placed him on a medical cot, removed a bloody bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to call his family member. “A piece of mortar hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. That will take a several months. Subsequently, to go back to my unit. Someone has to protect our country,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the back by a piece of artillery shell.

Since 2022, Russia has consistently targeted hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, earth and sand placed above reaching the surface. It is designed to resist impacts from 152mm artillery shells and even three 8kg explosive devices released by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to build 20 units in all. A senior official of Ukraine’s security agency and ex- military leader, the official, said they would be “critically important for saving the survival of our armed forces and assisting troops on the battlefront.” The organization described the initiative as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, said certain injured personnel had to endure delays many hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had two severely injured patients who arrived at 3am. It was necessary to perform a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” How did he cope with traumatic operations? “My career in medicine for 20 years. You have to concentrate,” he remarked.

Orderlies wheeled the soldier 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 urban center of a major city for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, walked toward the entrance to await the incoming patients. “We are active around the clock,” Holovashchenko said. “The work is continuous.”