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Scrubby trees hide the entryway. One sloping timber tunnel descends to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and neat piles of extra garments. Within a break area with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an subterranean hospital look at a screen showing enemy suicide and surveillance UAVs in the region.

Welcome to Ukraine’s secret below-ground hospital. This center began operations in the eighth month and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are six meters below the earth. This is the safest way of delivering care to our injured soldiers. It also ensures healthcare workers protected,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point treats 30-40 casualties a each day. Cases differ widely. Some have devastating leg injuries requiring surgical removal, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of Russian FPV aerial devices, which release grenades with lethal precision. “90% of our cases are from FPVs. We see few bullet injuries. It’s an era of unmanned aircraft and a different kind of war,” the surgeon said.

Maj the senior surgeon at the underground installation for treating injured troops in eastern Ukraine.

On one afternoon recently, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a small hole in his limb. “War is horrific. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the enemy forces dropped a second explosive on him.” He added: “All structures in the village is demolished. We see drones all around and bodies. Ours and the enemy's.”

The soldier explained his unit endured over a month in a wooded zone near the city, which Russia has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions arrived by quadcopter: food and water. A week following he was hurt, he traveled 5km (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his vital signs. Following care, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of pale jeans.

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

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a trench shelter. Suddenly it became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was fortunate to survive. A relative has been killed. There are ongoing detonations.” A construction worker working in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a stained dressing and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. This may require a few months. After that, to return to my military group. Someone must protect our country,” he said.

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

Over the past years, Russia has repeatedly targeted hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, over two hundred medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is built from four reinforced shelters, with timber beams, soil and granular material placed above reaching ground level. It can withstand direct hits from large-caliber artillery shells and even three eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which funded the construction, 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 “critically essential for saving the survival of our armed forces and supporting troops on the frontline.” The company described the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, explained certain wounded soldiers had to wait many hours or even multiple days before they could be evacuated due to the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to perform a double amputation on a patient. The soldier's bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an emergency vehicle. The transport was parked beneath a shrub. He and the other soldiers were taken to the urban center of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s ginger cat, the mascot, walked toward the doorway to greet the incoming patients. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”