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Scrubby foliage conceal the entrance. One descending wooden tunnel leads down to a brightly lit reception area. There is a operating ward, equipped with beds, cardiac monitors and ventilators. Plus cabinets full of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a washing machine and hot water heater, doctors monitor a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital staff at an underground hospital observe a screen displaying Russian suicide and reconnaissance drones in the area.

This is Ukraine’s secret underground hospital. 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. “We are six meters below the ground. It’s the safest method of providing help to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring amputations, or serious stomach wounds. Others can walk. Almost all are the casualties of Russian FPV aerial devices, which drop grenades with lethal precision. “90% of our cases are from FPVs. We see minimal bullet injuries. It’s an age of drones and a different kind of war,” the surgeon said.

Major the senior surgeon at the underground installation for treating wounded soldiers in the eastern region.

On one afternoon recently, a group of three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a minor wound in his limb. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the Russians dropped a second explosive on him.” He added: “Everything in the settlement is demolished. We see UAVs all around and casualties. Our side's and theirs.”

The soldier said his unit spent 43 days in a forest area near the city, which enemy forces has been attempting to capture for many months. Sole access to reach their position was by walking. All supplies came by drone: food and water. Seven days after he was hurt, he traveled 5km (about 3 miles), taking three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, 28, said a first-person view drone caused a small hole in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been lost. We face continuous explosions.” A construction worker working in a neighboring country, he said he had come back to his homeland and volunteered to serve days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a bed, removed a bloody dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his family member. “A fragment of mortar struck me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. This may require a few months. Subsequently, to return to my military group. Someone must defend our country,” he said.

Doctors treat the wounded soldier, who was hit in the back by a piece of mortar.

Over the past years, enemy forces has repeatedly attacked hospitals, health facilities, obstetric units and ambulances. Per human rights groups, 261 medical personnel have been fatally attacked in almost 2,000 assaults. This subterranean hospital is built from four reinforced shelters, with wooden supports, soil and sand placed above up to the surface. It can withstand direct hits from 152mm projectiles and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, plans to build 20 facilities in all. A senior official of the nation's national security council and ex- military leader, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and supporting defenders on the battlefront.” The company described the initiative as the “largest-scale and demanding” it had implemented after the enemy's invasion.

One of the facility's operating theatres.

Holovashchenko, said certain injured personnel had to endure delays many hours or even multiple days before they could be transported due to the threat of aerial attacks. “Our facility received two critically ill patients who arrived at 3am. I had to perform a double amputation on a patient. His bleeding control device had been applied for such an extended period there was no other option.” What is his method with traumatic surgeries? “I’ve been healthcare for two decades. You have to focus,” he remarked.

Orderlies transported the soldier through the tunnel and into an ambulance. The vehicle was stationed beneath a shrub. The patient and the two other military members were transferred to the urban center of a major city for further treatment. The underground medical team took a break. The hospital’s orange feline, the mascot, padded toward the doorway to greet the incoming patients. “We are active 24 hours a day,” Holovashchenko stated. “The work is continuous.”