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Scrubby trees hide the entrance. One descending wooden passageway descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets full of healthcare supplies, medications and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Hospital personnel at an subterranean medical center look at a monitor showing enemy suicide and surveillance drones in the region.

Welcome to Ukraine’s covert underground hospital. This center opened in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. It’s the safest method of providing help to our wounded soldiers. It also ensures medical personnel safe,” stated the clinic’s surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or severe stomach wounds. Some patients can walk. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which release grenades with deadly precision. “90% of our cases are from FPVs. We encounter minimal gunshot wounds. It’s an age of drones and a different kind of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean facility for treating wounded troops in eastern Ukraine.

On one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a minor wound in his limb. “Conflict is terrible. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the enemy forces released a another grenade on him.” He continued: “All structures in the village is demolished. There are drones everywhere and bodies. Ours and the enemy's.”

Dvorskyi explained his squad spent over a month in a forest area near the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was by walking. Necessary provisions arrived by drone: food and water. A week after he was injured, he walked five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic checked his vital signs. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a pair of pale jeans.

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

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he said. “I believe I was lucky to remain alive. A relative has been lost. There are ongoing detonations.” A construction worker employed in a neighboring country, he noted he had returned to his homeland and volunteered to fight days before the Russian leader's large-scale attack in February 2022.

Another military member, 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 cleaned his recent injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A fragment of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. After that, to go back to my military group. Someone must protect our country,” he affirmed.

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

Over the past years, enemy forces has consistently attacked medical centers, clinics, obstetric units and ambulances. Per international monitors, 261 medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, soil and sand laid on top reaching ground level. It can withstand impacts from 152mm projectiles and even multiple 8kg TNT charges released by drone.

The Ukrainian industrial group, which financed the construction, intends to build twenty facilities in all. The head of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the survival of our armed forces and supporting troops on the battlefront.” The organization referred to the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said some wounded personnel had to endure delays hours or even days before they could be evacuated due to the danger of aerial attacks. “We had a pair of severely injured casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on a patient. The soldier's tourniquet had been applied for such an extended period there was no alternative.” How did he cope with severe surgeries? “I’ve been medicine for two decades. You have to focus,” he said.

Medical assistants wheeled the soldier through the tunnel and into an ambulance. The vehicle was parked beneath a shrub. He and the other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean medical team took a break. The facility's orange feline, the mascot, walked toward the doorway to greet the next arrivals. “We are active 24 hours a day,” Holovashchenko said. “The work is continuous.”