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Scrubby trees hide the entrance. One descending wooden tunnel leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And shelves full of medical equipment, drugs and organized stacks of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the air above.

Medical staff at an subterranean hospital look at a screen displaying Russian kamikaze and reconnaissance drones in the region.

Welcome to the nation's covert underground medical facility. This center opened in August and is the second of its kind, located 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 method of delivering care to our injured soldiers. It also ensures healthcare workers safe,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries requiring amputations, or severe abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which release grenades with deadly accuracy. “Ninety per cent of our cases are from FPVs. We see few bullet injuries. It’s an age of drones and a different kind of war,” the doctor explained.

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

On one afternoon recently, three soldiers limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an first-person view drone blast had torn a minor wound in his leg. “War is terrible. The guy next to me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians dropped a another explosive on him.” He continued: “Everything in the village is demolished. There are drones all around and casualties. Our side's and theirs.”

The soldier said his unit endured over a month in a forest area near the city, which enemy forces has been trying to seize since last year. Sole access to get to their location was on foot. Necessary provisions arrived by drone: rations and water. A week after he was hurt, he walked 5km (roughly three miles), taking several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a T-shirt and a set of light-colored jeans.

The soldier, twenty-eight, stated a FPV drone ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a drone blast had resulted in a head injury. “I was in a trench shelter. It suddenly went dark. I couldn’t feel anything or hear anything,” he explained. “I think I was lucky to survive. My cousin has been lost. We face continuous explosions.” A builder employed in Lithuania, he noted he had come back to his homeland and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors placed him on a bed, removed a bloody dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his sister. “A piece of artillery struck me. The cause was a ricochet. 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. Our forces must defend our nation,” he said.

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

Since 2022, Russia has repeatedly targeted hospitals, clinics, obstetric units and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in nearly 2,000 assaults. The underground facility is built from four reinforced shelters, with wooden supports, soil and granular material laid on top reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg explosive devices dropped by aerial means.

The Ukrainian industrial group, which funded the building, intends to erect 20 units in total. A senior official of Ukraine’s national security council and former defence minister, Rustem Umerov, said they would be “critically essential for saving the survival of our armed forces and assisting defenders on the battlefront.” The organization referred to the project as the “most ambitious and challenging” it had undertaken since the enemy's invasion.

One of the centre’s surgical rooms.

Holovashchenko, said some wounded soldiers had to endure delays many hours or even days before they could be evacuated due to the danger of aerial attacks. “We had two severely injured casualties who came at 3am. I had to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no alternative.” What is his method with severe surgeries? “I’ve been healthcare for two decades. You have to focus,” he remarked.

Orderlies wheeled Mykolaichuk through the passage and into an ambulance. The vehicle was parked beneath a shrub. He and the two other soldiers were taken to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked toward the doorway to greet the next arrivals. “We are active around the clock,” the surgeon said. “It doesn’t stop.”