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Sparse trees hide the entrance. A descending timber passageway descends to a well-illuminated welcome zone. There is a surgery unit, equipped with gurneys, heart rate sensors and ventilators. Plus shelves full of medical equipment, medications and organized stacks of spare clothes. Within a break area with a washing machine and kettle, physicians keep an eye on a screen. It shows the flight patterns of enemy spy drones as they zigzag in the sky above.

Medical staff at an underground hospital look at a screen displaying enemy kamikaze and reconnaissance drones in the region.

This is Ukraine’s secret underground hospital. The facility began operations in the eighth month and is the second of its kind, located in the eastern part of the country close to the combat zone and the city of Pokrovsk in the Donetsk region. “We are 6 metres under the earth. This is the most secure method of providing help to our injured soldiers. And it keeps healthcare workers protected,” stated the clinic’s surgeon, Maj the chief surgeon.

This medical station treats thirty to forty patients a day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring surgical removal, or severe stomach wounds. Others can move on their own. The vast majority are the casualties of enemy FPV drones, which drop explosives with deadly precision. “90% of our patients are from FPVs. We see minimal gunshot wounds. It’s an era of drones and a new type of war,” the surgeon explained.

Major the senior surgeon at the subterranean facility for treating injured troops in the eastern region.

During one day last week, a group of three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his limb. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Then the Russians released a second explosive on him.” He added: “All structures in the village is destroyed. We see UAVs everywhere and casualties. Ours and the enemy's.”

The soldier said his unit spent 43 days in a wooded zone near Pokrovsk, which Russia has been trying to seize for many months. Sole access to get to their location was by walking. All supplies arrived by drone: rations and water. Seven days after he was injured, he walked five kilometers (roughly three miles), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant provided him with new non-military attire: a T-shirt and a pair of pale denim trousers.

The soldier, 28, said a first-person view aerial device caused a small hole in his leg.

A different casualty, 38-year-old a serviceman, said a UAV explosion had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been lost. We face ongoing detonations.” A builder employed in a neighboring country, he noted he had come back to his homeland and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a medical cot, took off a bloody dressing and cleaned his recent shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to ring his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my military group. Someone has to defend our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Over the past years, Russia has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in nearly two thousand assaults. The underground facility is constructed from multiple steel bunkers, with timber beams, soil and sand placed above up to the surface. It can withstand impacts from large-caliber projectiles and even multiple 8kg explosive devices dropped by drone.

The Ukrainian industrial group, which financed the construction, plans to erect twenty facilities in all. The head of Ukraine’s national security council and former defence minister, the official, declared they would be “critically essential for preserving the lives of our military and supporting troops on the battlefront.” The organization described the initiative as the “largest-scale and demanding” it had implemented after Russia’s invasion.

An example of the facility's operating theatres.

The surgeon, said certain wounded soldiers had to wait many hours or even multiple days before they could be transported due to the danger of air assaults. “Our facility received a pair of severely injured casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe operations? “My career in healthcare for two decades. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. He and the two other military members were transferred to the city of Dnipro for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded toward the doorway to greet the next arrivals. “We are active 24 hours a day,” the surgeon stated. “The work is continuous.”