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Sparse trees hide the entrance. One descending timber passageway leads down to a brightly lit reception area. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. Plus shelves stocked of medical equipment, medications and organized stacks of extra garments. Within a staff room with a washing machine and kettle, physicians monitor a screen. It shows the flight patterns of Russian spy drones as they zigzag in the sky above.

Hospital personnel at an underground medical center observe a monitor displaying enemy suicide and reconnaissance drones in the region.

Welcome to the nation's covert underground hospital. This center began operations in the eighth month and is the second such installation, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the ground. This is the safest way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” stated the facility's lead doctor, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or serious abdominal injuries. Others can move on their own. Almost all are the victims of enemy first-person view (FPV) aerial devices, which release grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We encounter minimal bullet injuries. This is an era of drones and a new type of war,” the surgeon explained.

Maj the senior surgeon at the underground installation for caring for wounded troops in the eastern region.

On one day last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a minor wound in his limb. “War is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians dropped a another explosive on him.” He added: “All structures in the settlement is destroyed. There are UAVs all around and casualties. Ours and the enemy's.”

The soldier said his unit spent over a month in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies came by drone: rations and water. A week following he was injured, he traveled five kilometers (roughly three miles), taking three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a T-shirt and a set of light-colored jeans.

The soldier, 28, stated a first-person view drone ripped a small hole in his leg.

A different casualty, thirty-eight-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A construction worker employed in Lithuania, he noted he had come back to his homeland and enlisted to fight shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff placed him on a bed, removed a bloody bandage and treated his recent shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A piece of mortar hit me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. That will take a several months. After that, to return to my unit. Someone must protect our country,” he affirmed.

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

Since 2022, Russia has consistently attacked medical centers, health facilities, maternity wards and ambulances. Per international monitors, 261 health workers have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is built from four reinforced shelters, with timber beams, earth and sand laid on top up to ground level. It can withstand impacts from 152mm projectiles and even three 8kg explosive devices dropped by aerial means.

A major industrial group, which financed the construction, plans to build twenty facilities in all. The head of Ukraine’s national security council and ex- military leader, the official, declared they would be “vitally essential for preserving the lives of our armed forces and supporting defenders on the battlefront.” The company referred to the initiative as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

An example of the facility's operating theatres.

The surgeon, explained certain wounded personnel had to endure delays many hours or even days before they could be transported because of the danger of air assaults. “We had two critically ill patients who came at 3am. It was necessary to carry out a removal of both limbs on a patient. His tourniquet had been on for so long there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to focus,” he said.

Medical assistants wheeled the soldier through the tunnel and into an emergency vehicle. The transport was parked under a shrub. He and the other military members were taken to the urban center 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 doorway to await the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”