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Sparse foliage hide the entrance. A descending wooden tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, outfitted with beds, heart rate sensors and ventilators. And shelves full of healthcare supplies, medications and organized stacks of spare clothes. In a staff room with a washing machine and hot water heater, doctors monitor a screen. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital staff at an underground medical center look at a screen showing Russian kamikaze and reconnaissance drones in the region.

This is Ukraine’s secret below-ground hospital. The facility opened in the eighth month and is the second such installation, situated in the eastern part of the country close to the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the safest method of providing help to our wounded military personnel. And it keeps medical personnel protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating limb trauma necessitating amputations, or severe abdominal injuries. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an era of drones and a different kind of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for caring for wounded troops in eastern Ukraine.

On one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a small hole in his leg. “Conflict is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces dropped a second explosive on him.” He added: “Everything in the village is demolished. There are UAVs all around and casualties. Our side's and the enemy's.”

The soldier explained his squad spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was on foot. All supplies arrived by drone: rations and water. Seven days after he was injured, he walked five kilometers (roughly three miles), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a nurse provided him with fresh civilian clothes: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device caused a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in a head injury. “My position was in a dugout. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I think I was fortunate to remain alive. A relative has been killed. We face ongoing detonations.” A construction worker working in a neighboring country, he noted he had come back to his homeland and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a bed, removed a stained bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to call his family member. “A piece of artillery struck 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. Subsequently, to go back to my unit. Our forces has to protect our nation,” he said.

Medical staff 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, health facilities, obstetric units and ambulances. Per international monitors, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from four reinforced shelters, with timber beams, soil and granular material placed above reaching ground level. It can withstand direct hits from 152mm artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

The Ukrainian steel and mining company, which financed the building, intends to build twenty units in all. A senior official of the nation's security agency and ex- military leader, the official, declared they would be “critically important for saving the survival of our armed forces and assisting defenders on the battlefront.” The company described the project as the “largest-scale and challenging” it had undertaken since Russia’s military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, explained certain injured personnel had to wait many hours or even multiple days before they could be transported due to the danger of air assaults. “We had a pair of critically ill casualties who came at the early hours. It was necessary to carry out a removal of both limbs on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” What is his method with traumatic surgeries? “I’ve been medicine for two decades. One must focus,” he said.

Orderlies transported the soldier up the passage and into an ambulance. The vehicle was parked under a bush. He 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, walked up to the doorway to await the incoming patients. “We are open 24 hours a day,” Holovashchenko stated. “The work is continuous.”