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Sparse foliage hide the entrance. A descending timber tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, drugs and organized stacks of spare clothes. In a staff room with a washing machine and kettle, physicians keep an eye on a screen. It shows the movements of Russian spy drones as they weave in the air above.

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

This is the nation's covert below-ground medical facility. The facility opened in the eighth month and is the second such installation, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the most secure way of delivering care to our wounded military personnel. It also ensures healthcare workers safe,” stated the clinic’s surgeon, Major the chief surgeon.

The stabilisation point treats thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating amputations, or severe stomach wounds. Some patients can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release explosives with deadly accuracy. “Ninety per cent of our patients are from FPVs. We encounter few bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major the senior surgeon at the underground facility for treating wounded soldiers in eastern Ukraine.

On one afternoon recently, three military members walked with difficulty 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 limb. “Conflict is terrible. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a another grenade on him.” He added: “All structures in the village is destroyed. We see UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his unit endured 43 days in a forest area close to the city, which Russia has been trying to seize since last year. Sole access to get to their location was on foot. All supplies arrived by quadcopter: food and drinking water. Seven days following he was hurt, he walked five kilometers (roughly three miles), requiring several hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his physical condition. Following care, a nurse gave him new civilian clothes: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone caused a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “My position was in a dugout. It suddenly became black. I lost sensation any feeling or hear anything,” he said. “I think I was fortunate to remain alive. A relative has been lost. There are ongoing explosions.” A builder working in Lithuania, Filipchuk noted he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s full-scale invasion 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, took off a stained bandage and treated his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to ring his family member. “A piece of artillery struck me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. After that, to go back to my unit. Someone has to defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly targeted hospitals, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been killed in almost 2,000 assaults. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, soil and granular material placed above up to the surface. It can withstand direct hits from large-caliber artillery shells and even three 8kg explosive devices dropped by aerial means.

A major industrial group, which funded the construction, intends to build twenty units in total. A senior official of Ukraine’s national security council and ex- military leader, the official, declared they would be “vitally essential for preserving the lives of our military and assisting troops on the battlefront.” The company described the project as the “most ambitious and challenging” it had implemented after the enemy's invasion.

An example of the facility's operating theatres.

The surgeon, said some injured soldiers had to endure delays many hours or even days before they could be evacuated due to the danger of air assaults. “We had a pair of severely injured patients who arrived at 3am. It was necessary to perform a double amputation on a patient. His tourniquet had been on for such an extended period there was no other option.” How did he cope with traumatic surgeries? “My career in healthcare for two decades. You have to concentrate,” he remarked.

Orderlies wheeled the soldier up the tunnel and into an emergency vehicle. The transport was stationed beneath a shrub. The patient and the other soldiers were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded up to the doorway to greet the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”