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Sparse foliage conceal the entrance. A descending wooden tunnel leads down to a well-illuminated reception area. There is a operating ward, outfitted with gurneys, heart rate sensors and ventilators. Plus cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a washing machine and kettle, physicians monitor a display. The screen reveals the movements of enemy spy drones as they weave in the air above.

Hospital personnel at an underground medical center observe a monitor showing Russian kamikaze and surveillance drones in the area.

This is Ukraine’s secret below-ground hospital. The facility began operations in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “We are six meters below the ground. It’s the safest way of delivering care to our wounded soldiers. It also ensures medical personnel safe,” said the facility's surgeon, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or serious stomach wounds. Some patients can walk. Almost all are the victims of enemy first-person view (FPV) drones, which drop explosives with lethal precision. “Ninety per cent of our patients are from FPVs. We see minimal bullet injuries. It’s an age of drones and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for injured troops in eastern Ukraine.

On one afternoon last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had ripped a minor wound in his leg. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians released a second grenade on him.” He added: “All structures in the village is destroyed. We see drones all around and bodies. Our side's and the enemy's.”

Dvorskyi explained his unit endured over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to reach their position was on foot. Necessary provisions arrived by drone: rations and water. Seven days after he was hurt, he walked 5km (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. At the clinic, a medic checked his vital signs. Following care, a medical attendant gave him fresh non-military attire: a shirt and a set of pale jeans.

Artem Dvorskiy, 28, said a FPV drone caused a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “I was in a dugout. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he said. “I think I was fortunate to survive. My cousin has been killed. We face ongoing explosions.” A builder working in Lithuania, he noted he had returned to his homeland and enlisted to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff laid him on a medical cot, took off a bloody bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to call his family member. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to return to my unit. Our forces has to protect our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the back by a fragment of mortar.

Since 2022, Russia has consistently targeted medical centers, health facilities, obstetric units and ambulances. Per human rights groups, over two hundred medical personnel have been killed in nearly 2,000 assaults. The underground facility is constructed from four reinforced shelters, with timber beams, earth and sand placed above reaching ground level. It is designed to resist impacts from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by drone.

A major steel and mining company, which financed the building, plans to erect twenty units in all. A senior official of Ukraine’s national security council and ex- military leader, the official, declared they would be “vitally essential for saving the survival of our military and assisting troops on the battlefront.” The company described the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

An example of the facility's operating theatres.

The surgeon, said certain wounded personnel had to endure delays hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received two severely injured casualties who arrived at the early hours. I had to perform a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic surgeries? “I’ve been healthcare for two decades. You have to focus,” he said.

Medical assistants transported Mykolaichuk up the tunnel and into an ambulance. The transport was parked beneath a shrub. He and the other soldiers were transferred to the city of a major city for additional medical care. The subterranean hospital staff paused for rest. The facility's orange feline, the mascot, padded up to the entrance to await the next arrivals. “Our facility operates active around the clock,” the surgeon said. “The work is continuous.”