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Scrubby trees conceal the entrance. One sloping wooden tunnel descends to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, medications and neat piles of spare clothes. Within a staff room with a washing machine and kettle, doctors keep an eye on a screen. The screen reveals the movements of Russian surveillance UAVs as they weave in the air above.

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

This is the nation's covert below-ground hospital. The facility began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters under the earth. It’s the most secure way of delivering care to our wounded military personnel. It also ensures medical personnel safe,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 patients a each day. Their conditions vary. Some have catastrophic limb trauma necessitating amputations, or serious stomach wounds. Others can move on their own. The vast majority are the victims of enemy FPV aerial devices, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We see minimal gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the doctor said.

Major the senior surgeon at the subterranean installation for treating injured soldiers in the eastern region.

During one day last week, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV explosion had ripped a minor wound in his limb. “War is terrible. The guy beside me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the enemy forces dropped a another grenade on him.” He added: “All structures in the settlement is destroyed. There are UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad spent 43 days in a wooded zone close to Pokrovsk, which Russia has been attempting to capture for many months. The only way to reach their position was by walking. Necessary provisions arrived by drone: food and water. Seven days after he was hurt, he walked 5km (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his vital signs. After treatment, a medical attendant gave him new non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “I was in a trench shelter. It suddenly went dark. I couldn’t feel anything or any sound,” he explained. “I think I was fortunate to remain alive. My cousin has been lost. We face continuous explosions.” A construction worker employed in Lithuania, he said he had come back to his homeland and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors placed him on a bed, took off a bloody bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his sister. “A fragment of artillery struck me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. After that, to return to my military group. Our forces has to defend our country,” he said.

Medical staff treat the wounded soldier, who was hit in the dorsal area by a fragment of artillery shell.

Since 2022, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is built from multiple steel bunkers, with wooden supports, soil and granular material laid on top reaching ground level. It can withstand direct hits from 152mm artillery shells and even three 8kg explosive devices released by drone.

A major steel and mining company, which funded the construction, plans to build 20 facilities in all. A senior official of Ukraine’s national security council and ex- defence minister, the official, declared they would be “critically essential for saving the survival of our military and supporting troops on the frontline.” The company described the initiative as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, explained 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 two severely injured patients who arrived at the early hours. I had to carry out a removal of both limbs on one of them. The soldier's tourniquet had been on for so long there was no other option.” What is his method with severe surgeries? “My career in healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants wheeled the soldier up the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the other soldiers were taken to the city of a major city for additional medical care. The subterranean hospital staff paused for rest. The hospital’s ginger cat, the mascot, padded toward the entrance to greet the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”