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Scrubby foliage hide the entryway. A descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and ventilators. And shelves full of medical equipment, drugs and organized stacks of spare clothes. In a staff room with a laundry appliance and hot water heater, doctors monitor a screen. It shows the movements of Russian spy drones as they weave in the sky above.

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

Welcome to Ukraine’s secret underground hospital. The facility began operations in the eighth month and is the second such installation, situated in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “We are six meters below the earth. This is the safest way of delivering care to our wounded military personnel. It also ensures medical personnel safe,” stated the clinic’s surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries requiring amputations, or severe abdominal injuries. Some patients can walk. Almost all are the victims of Russian FPV drones, which release grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground installation for treating injured troops in eastern Ukraine.

On one day recently, three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a minor wound in his limb. “War is horrific. My comrade next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He added: “All structures in the settlement is demolished. We see drones all around and casualties. Ours and theirs.”

The soldier explained his squad spent 43 days in a forest area near Pokrovsk, which Russia has been attempting to capture since last year. The only way to get to their location was on foot. All supplies came by drone: rations and water. A week after he was hurt, he walked 5km (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse provided him with fresh non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. It suddenly became black. I lost sensation any feeling or any sound,” he explained. “I believe I was lucky to remain alive. A relative has been killed. There are continuous detonations.” A construction worker employed in a neighboring country, he said he had come back to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been hit in the back. He groaned as doctors laid him on a bed, took off a stained dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A piece of artillery struck me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my military group. Our forces has to defend our nation,” he said.

Doctors care for the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently attacked medical centers, clinics, obstetric units and ambulances. According to human rights groups, over two hundred health workers have been killed in nearly two thousand attacks. The underground facility is constructed from four reinforced shelters, with wooden supports, soil and sand laid on top up to the surface. It can withstand impacts from 152mm artillery shells and even three 8kg explosive devices released by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build twenty facilities in all. The head of Ukraine’s security agency and former defence minister, Rustem Umerov, declared they would be “critically essential for preserving the lives of our military and supporting defenders on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken since the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said certain injured personnel had to endure delays many hours or even multiple days before they could be evacuated due to the danger of air assaults. “We had two severely injured patients who arrived at the early hours. I had to carry out a double amputation on one of them. The soldier's bleeding control device had been on for so long there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for 20 years. One must focus,” he remarked.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The transport was stationed under a bush. The patient and the other military members were transferred to the city of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, walked up to the doorway to await the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”