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Sparse trees hide the entrance. One descending wooden passageway leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with beds, heart rate sensors and breathing machines. Plus shelves full of healthcare supplies, medications and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a screen. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Medical personnel at an underground hospital look at a screen displaying Russian kamikaze and surveillance drones in the area.

This is the nation'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 not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. It’s the most secure way of delivering care to our injured soldiers. And it keeps healthcare workers protected,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 casualties a each day. Their conditions vary. Some have devastating limb trauma requiring surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the victims of Russian first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a new type of war,” the surgeon explained.

Maj the senior surgeon at the underground installation for treating injured troops in the eastern region.

During one afternoon recently, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his limb. “War is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a second explosive on him.” He added: “Everything in the settlement is demolished. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi explained his squad spent 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was on foot. Necessary provisions came by quadcopter: food and water. A week after he was injured, he traveled five kilometers (roughly three miles), requiring three hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his vital signs. Following care, a nurse gave him new civilian clothes: a shirt and a pair of light-colored jeans.

The soldier, twenty-eight, said a FPV aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I believe I was fortunate to remain alive. A relative has been killed. There are continuous detonations.” A builder working in Lithuania, Filipchuk said 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, a serviceman, had been struck in the upper body. He expressed pain as doctors placed him on a medical cot, took off a bloody dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his family member. “A fragment of mortar hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. This may require a several months. After that, to return to my unit. Our forces has to defend our nation,” he affirmed.

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 attacked hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in almost 2,000 assaults. The underground facility is built from four steel bunkers, with wooden supports, soil and granular material laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple eight-kilogram explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the building, plans to build twenty units in total. A senior official of Ukraine’s national security council and former military leader, Rustem Umerov, said they would be “critically essential for preserving the lives of our armed forces and supporting troops on the battlefront.” The company described the project as the “most ambitious and demanding” it had implemented after the enemy's invasion.

An example of the centre’s operating theatres.

Holovashchenko, said some wounded personnel had to wait hours or even days before they could be transported because of the danger of air assaults. “Our facility received two critically ill patients who arrived at 3am. I had to perform a double amputation on a patient. The soldier's tourniquet had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been medicine for 20 years. You have to concentrate,” he remarked.

Orderlies wheeled the soldier through the tunnel and into an ambulance. The vehicle was parked under a bush. The patient and the two other military members were transferred to the urban center of a major city for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, the mascot, walked up to the entrance to greet the next arrivals. “We are open around the clock,” the surgeon said. “It doesn’t stop.”