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Scrubby foliage conceal 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 ventilators. And cabinets full of healthcare supplies, medications and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a screen. It shows the movements of enemy spy drones as they weave in the sky above.

Hospital staff at an underground hospital observe a screen displaying enemy kamikaze and reconnaissance UAVs in the region.

This is Ukraine’s secret below-ground medical facility. This center opened in August and is the second such installation, located in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres below the ground. This is the safest method of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Major the chief surgeon.

The stabilisation point treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring amputations, or serious abdominal injuries. Some patients can walk. Almost all are the victims of enemy FPV drones, which drop explosives with deadly precision. “90% of our patients are from FPVs. We see few gunshot wounds. This is an age of drones and a different kind of conflict,” the doctor explained.

Major the senior surgeon at the subterranean facility for treating injured troops in the eastern region.

On one day recently, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a small hole in his limb. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces released a second grenade on him.” He continued: “Everything in the village is demolished. There are UAVs all around and bodies. Ours and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone close to the city, which enemy forces has been attempting to capture since last year. The only way to get to their location was on foot. Necessary provisions came by quadcopter: rations and water. Seven days following he was injured, he walked five kilometers (roughly three miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medic assessed his physical condition. Following care, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, 28, said a FPV drone ripped a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he said. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous explosions.” A builder working in Lithuania, he said he had returned to Ukraine and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as doctors placed him on a medical cot, took off a bloody dressing and treated his recent shrapnel wound. Covered in a foil blanket, he used a cellphone to call his sister. “A fragment of artillery struck me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. This may require a several months. After that, to go back to my unit. Our forces must defend our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Over the past years, enemy forces has consistently targeted medical centers, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, soil and sand laid on top up to the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which funded the construction, plans to erect twenty units in all. The head of Ukraine’s security agency and former military leader, Rustem Umerov, declared they would be “critically important for saving the survival of our armed forces and assisting defenders on the battlefront.” The company referred to the project as the “largest-scale and demanding” it had undertaken since Russia’s military offensive.

An example of the centre’s surgical rooms.

The surgeon, said certain injured personnel had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “Our facility received a pair of severely injured casualties who arrived at 3am. It was necessary to carry out a double amputation on one of them. The soldier's tourniquet had been on for so long there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for two decades. You have to focus,” he said.

Medical assistants wheeled the soldier up the tunnel and into an emergency vehicle. The vehicle was stationed beneath a bush. The patient and the other military members were transferred to the city of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, padded toward the entrance to await the incoming patients. “Our facility operates active around the clock,” Holovashchenko said. “The work is continuous.”