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Scrubby foliage conceal the entrance. A sloping timber passageway descends to a well-illuminated reception area. There is a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. Plus cabinets stocked of healthcare supplies, medications and organized stacks of extra garments. Within a break area with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of Russian spy drones as they weave in the air above.

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

This is Ukraine’s covert below-ground hospital. This center began operations in the eighth month and is the second of its kind, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters below the ground. This is the most secure method of delivering care to our wounded military personnel. And it keeps medical personnel safe,” stated the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles 30-40 patients a day. Cases differ widely. Some have catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which drop grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor said.

Major Oleksandr Holovashchenko at the subterranean installation for treating wounded soldiers in eastern Ukraine.

During one afternoon recently, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone explosion had ripped a small hole in his limb. “War is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a another explosive on him.” He continued: “Everything in the village is demolished. There are drones all around and bodies. Our side's and the enemy's.”

Dvorskyi said his unit endured 43 days in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. The only way to reach their location was on foot. All supplies came by quadcopter: food and drinking water. Seven days following he was injured, he traveled 5km (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his physical condition. Following care, a nurse provided him with new civilian clothes: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, stated a FPV aerial device caused a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was lucky to remain alive. My cousin has been lost. We face ongoing detonations.” A construction worker employed in Lithuania, he said he had returned to his homeland and volunteered to fight days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a bloody dressing and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a mobile phone to call his sister. “A fragment of mortar hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my unit. Our forces has to defend our nation,” he affirmed.

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

Since 2022, enemy forces has consistently targeted medical centers, clinics, obstetric units and ambulances. According to international monitors, 261 health workers have been killed in almost 2,000 attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and granular material placed above up to the surface. It can withstand impacts from large-caliber projectiles and even three eight-kilogram TNT charges dropped by drone.

A major industrial group, which funded the building, plans to build 20 facilities in all. A senior official of the nation's security agency and former defence minister, Rustem Umerov, said they would be “vitally essential for preserving the lives of our armed forces and assisting troops on the battlefront.” The company referred to the initiative as the “most ambitious and challenging” it had implemented after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, explained certain injured personnel had to endure delays many hours or even days before they could be evacuated due to the threat of air assaults. “Our facility received a pair of critically ill patients who came at 3am. It was necessary to perform a double amputation on a patient. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been healthcare for two decades. You have to concentrate,” he remarked.

Orderlies transported Mykolaichuk through the passage and into an emergency vehicle. The vehicle was parked beneath a bush. He and the other soldiers were transferred to the city of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, Vasilevs, walked up to the doorway to greet the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”