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Scrubby foliage hide the entryway. A sloping timber tunnel leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital look at a monitor showing enemy suicide and surveillance drones in the region.

This is Ukraine’s covert below-ground hospital. This center opened in August and is the second of its kind, located in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters under the ground. This is the safest method of providing help to our injured soldiers. And it keeps medical personnel protected,” stated the clinic’s surgeon, Major the chief surgeon.

This medical station handles 30-40 casualties a day. Their conditions vary. Some have catastrophic leg injuries necessitating amputations, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy FPV aerial devices, which drop explosives with lethal precision. “90% of our cases are from FPVs. We encounter few bullet injuries. It’s an era of unmanned aircraft and a new type of war,” the doctor said.

Major the senior surgeon at the subterranean installation for treating wounded troops in eastern Ukraine.

On one day recently, a group of three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “Conflict is terrible. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces dropped a another explosive on him.” He continued: “Everything in the village is demolished. We see drones everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his squad endured over a month in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions arrived by drone: food and water. A week following he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant provided him with new civilian clothes: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, stated a FPV drone caused a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “My position was in a dugout. It suddenly became black. I couldn’t feel anything or any sound,” he said. “I think I was lucky to remain alive. A relative has been killed. 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 the Russian leader's large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a bed, removed a stained dressing and treated his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A fragment of artillery struck me. It was a ricochet. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a several months. After that, to return to my military group. Someone has to protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Since 2022, enemy forces has consistently attacked hospitals, health facilities, obstetric units and ambulances. Per international monitors, 261 medical personnel have been killed in nearly two thousand assaults. This subterranean hospital is built from multiple steel bunkers, with timber beams, earth and granular material placed above reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg explosive devices released by aerial means.

A major industrial group, which financed the construction, intends to build 20 units in all. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, said they would be “vitally essential for saving the lives of our armed forces and assisting troops on the frontline.” The organization referred to the project as the “most ambitious and demanding” it had implemented since the enemy's military offensive.

One of the facility's surgical rooms.

The surgeon, explained certain injured personnel had to wait hours or even days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill casualties who arrived at the early hours. I had to perform a removal of both limbs on a patient. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Orderlies transported Mykolaichuk through the tunnel and into an ambulance. The vehicle was stationed under a shrub. The patient and the two other military members were transferred to the urban center of a major city for additional medical care. The subterranean medical team took a break. The facility's orange feline, Vasilevs, padded toward the doorway to await the incoming patients. “We are open around the clock,” Holovashchenko said. “It doesn’t stop.”