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Scrubby trees hide the entryway. A sloping timber tunnel leads down to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus shelves full of healthcare supplies, drugs and neat piles of extra garments. In a staff room with a washing machine and hot water heater, doctors keep an eye on a screen. It shows the movements of Russian spy drones as they zigzag in the air above.

Medical personnel at an subterranean hospital look at a monitor showing enemy suicide and surveillance UAVs in the area.

This is Ukraine’s covert underground hospital. The facility opened in the eighth month and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters under the ground. This is the safest method of delivering care to our wounded military personnel. It also ensures medical personnel safe,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty casualties a day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or severe stomach wounds. Others can move on their own. The vast majority are the victims of Russian first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our patients are from first-person view drones. We encounter few bullet injuries. It’s an era of drones and a different kind of conflict,” the surgeon said.

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

On one day recently, three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his limb. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the Russians dropped a second explosive on him.” He continued: “All structures in the village is destroyed. We see UAVs all around and casualties. Our side's and the enemy's.”

The soldier said his squad spent 43 days in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to reach their location was by walking. Necessary provisions arrived by drone: rations and water. Seven days after he was hurt, he traveled 5km (about 3 miles), requiring three hours, to a point where an military transport was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse gave him fresh non-military attire: a shirt and a set of light-colored jeans.

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

Another patient, 38-year-old a serviceman, recounted a drone blast had left him with concussion. “My position was in a trench shelter. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face continuous detonations.” A builder working in Lithuania, he said he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as doctors laid him on a bed, 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 piece of artillery struck me. It was a ricochet. I’m OK,” he told her. What comes next for him? “To get better. That will take a few months. After that, to go back to my unit. Our forces must defend our country,” he said.

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

Over the past years, Russia has repeatedly attacked hospitals, health facilities, maternity wards and ambulances. According to international monitors, 261 medical personnel have been killed in almost two thousand attacks. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and sand placed above up to the surface. It is designed to resist direct hits from large-caliber projectiles and even multiple 8kg TNT charges dropped by drone.

A major steel and mining company, which funded the building, intends to erect twenty units in all. A senior official of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “vitally essential for saving the survival of our military and supporting defenders on the frontline.” The organization described the project as the “most ambitious and challenging” it had implemented since Russia’s invasion.

One of the centre’s operating theatres.

Holovashchenko, said certain wounded soldiers had to wait hours or even multiple days before they could be evacuated because of the danger of aerial attacks. “Our facility received two critically ill casualties who arrived at the early hours. I had to perform a double amputation on one of them. His tourniquet had been on for so long there was no other option.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Orderlies transported the soldier up the tunnel and into an ambulance. The transport was parked under a bush. The patient and the two other military members were transferred to the urban center of Dnipro for additional medical care. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded toward the doorway to greet the incoming patients. “We are active around the clock,” Holovashchenko said. “It doesn’t stop.”