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Sparse trees hide the entryway. One descending timber tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, heart rate sensors and breathing machines. And shelves stocked of healthcare supplies, medications and organized stacks of extra garments. In a staff room with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Medical staff at an underground medical center observe a screen showing enemy suicide and reconnaissance drones in the region.

This is Ukraine’s covert below-ground hospital. This center opened in August and is the second of its kind, situated in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. It’s the safest way of providing help to our injured military personnel. And it keeps healthcare workers protected,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty patients a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring amputations, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which drop grenades with lethal precision. “90% of our patients are from first-person view drones. We see few gunshot wounds. This is an age of drones and a different kind of war,” the surgeon said.

Major Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in eastern Ukraine.

During one afternoon last week, a group of three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old one soldier, said an FPV explosion had ripped a minor wound in his leg. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the Russians released a second grenade on him.” He continued: “All structures in the settlement is destroyed. There are drones all around and casualties. Ours and theirs.”

The soldier explained his squad spent over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their position was on foot. All supplies came by drone: food and water. A week following he was injured, he walked 5km (roughly three miles), requiring several hours, to where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant gave him new non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, stated a FPV aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he said. “I believe I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A construction worker employed in a neighboring country, Filipchuk said he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as doctors laid him on a bed, took off a stained dressing 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 struck me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. Subsequently, to return to my unit. Someone must defend our nation,” he said.

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

Over the past years, Russia has repeatedly attacked medical centers, clinics, obstetric units and ambulances. Per human rights groups, over two hundred health workers have been killed in almost 2,000 assaults. This subterranean hospital is constructed from four steel bunkers, with timber beams, earth and granular material placed above up to the surface. It can withstand impacts from large-caliber artillery shells and even multiple eight-kilogram explosive devices dropped by drone.

The Ukrainian industrial group, which funded the construction, intends to erect twenty units in all. A senior official of Ukraine’s national security council and former military leader, the official, said they would be “critically important for preserving the lives of our military and supporting defenders on the frontline.” The company described the project as the “largest-scale and challenging” it had implemented after the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said certain injured personnel had to endure delays many hours or even days before they could be transported due to the threat of aerial attacks. “We had a pair of 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 so long there was no other option.” How did he cope with traumatic operations? “My career in healthcare for two decades. You have to concentrate,” he remarked.

Orderlies wheeled the soldier through the passage and into an ambulance. The transport was parked under a shrub. The patient and the other soldiers were transferred to the city of a major city for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, the mascot, padded toward the doorway to greet the incoming patients. “Our facility operates active around the clock,” Holovashchenko said. “It doesn’t stop.”