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Sparse foliage conceal the entrance. A descending wooden tunnel descends to a brightly lit welcome zone. There is a operating ward, outfitted with beds, cardiac monitors and ventilators. And shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Hospital staff at an subterranean medical center observe a screen displaying enemy kamikaze and surveillance UAVs in the area.

Welcome to Ukraine’s secret underground hospital. The facility began operations in the eighth month and is the second such installation, located in the eastern part of the country close to the frontline and the city of Pokrovsk in Donetsk oblast. “We are six meters under the earth. It’s the safest method of providing help to our injured military personnel. And it keeps medical personnel safe,” stated the facility's lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or severe stomach wounds. Others can walk. The vast majority are the casualties of enemy FPV drones, which drop explosives with lethal accuracy. “Ninety per cent of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon said.

Maj the senior surgeon at the subterranean installation for caring for injured soldiers in the eastern region.

On one afternoon recently, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a small hole in his limb. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces released a second grenade on him.” He continued: “Everything in the settlement is demolished. There are drones all around and casualties. Our side's and the enemy's.”

Dvorskyi said his unit spent over a month in a forest area close to the city, which enemy forces has been trying to seize for many months. Sole access to reach their location was by walking. All supplies came by drone: food and drinking water. Seven days after he was hurt, he walked 5km (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a set of pale denim trousers.

The soldier, twenty-eight, said a first-person view drone ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had resulted in concussion. “My position was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I think I was lucky to remain alive. My cousin has been killed. There are ongoing explosions.” A builder employed in a neighboring country, he said he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as doctors placed him on a medical cot, took off a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his family member. “A fragment of mortar struck me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. That will take a several months. After that, to go back to my unit. Someone has to protect our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. Per international monitors, 261 medical personnel have been fatally attacked in almost two thousand assaults. This subterranean hospital is built from four reinforced shelters, with wooden supports, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three 8kg TNT charges released by aerial means.

A major steel and mining company, which financed the building, plans to erect twenty units in total. A senior official of the nation's security agency and ex- defence minister, the official, declared they would be “critically essential for preserving the survival of our armed forces and supporting defenders on the frontline.” The company described the initiative as the “largest-scale and demanding” it had undertaken since Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, said some injured soldiers had to wait many hours or even days before they could be transported due to the danger of aerial attacks. “We had two severely injured casualties who came at the early hours. It was necessary to carry out a removal of both limbs on one of them. The soldier's tourniquet had been applied for so long there was no other option.” How did he cope with severe operations? “My career in medicine for 20 years. You have to concentrate,” he said.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The transport was parked under a shrub. The patient and the two other military members were transferred to the city of a major city for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, the mascot, walked up to the doorway to greet the incoming patients. “Our facility operates active around the clock,” Holovashchenko stated. “It doesn’t stop.”