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Sparse trees hide the entrance. A descending timber passageway descends to a well-illuminated reception area. There is a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus cabinets stocked of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Medical personnel at an underground hospital observe a monitor showing Russian suicide and surveillance drones in the region.

Welcome to Ukraine’s covert underground medical facility. The facility began operations in August and is the second such installation, situated in eastern Ukraine close to the frontline and the urban area of Pokrovsk in the Donetsk region. “Our facility sits 6 metres under the earth. This is the safest way of delivering care to our injured military personnel. It also ensures healthcare workers safe,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have catastrophic leg injuries requiring amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the victims of Russian FPV drones, which drop grenades with lethal precision. “Ninety per cent of our patients are from FPVs. We see few bullet injuries. It’s an age of unmanned aircraft and a new type of war,” the surgeon explained.

Major the senior surgeon at the underground facility for caring for injured soldiers in eastern Ukraine.

During one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “War is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He continued: “All structures in the settlement is destroyed. There are drones everywhere and casualties. Ours and theirs.”

The soldier explained his squad endured 43 days in a forest area near the city, which enemy forces has been attempting to capture since last year. Sole access to get to their position was on foot. All supplies arrived by drone: food and water. Seven days after he was hurt, he traveled 5km (about 3 miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. After treatment, a medical attendant gave him new civilian clothes: a shirt and a pair of pale jeans.

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

A different casualty, 38-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “I was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been lost. We face continuous detonations.” A builder working in Lithuania, Filipchuk said he had returned to Ukraine and enlisted to fight days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as medical staff laid him on a bed, removed a stained bandage and treated his recent shrapnel wound. Covered in a foil blanket, he used a mobile phone to ring his sister. “A fragment 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 return to my military group. Someone must protect our country,” he said.

Doctors care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly attacked medical centers, health facilities, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is built from multiple steel bunkers, with wooden supports, earth and sand placed above up to ground level. It is designed to resist impacts from 152mm artillery shells and even three eight-kilogram explosive devices dropped by drone.

The Ukrainian steel and mining company, which financed the construction, intends to erect twenty facilities in total. A senior official of the nation's national security council and former defence minister, the official, declared they would be “vitally important for preserving the lives of our armed forces and assisting troops on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, said certain injured soldiers had to wait hours or even days before they could be transported because of the threat of air assaults. “Our facility received a pair of severely injured casualties who arrived at 3am. It was necessary to carry out a double amputation on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with traumatic operations? “My career in healthcare for 20 years. One must concentrate,” he remarked.

Orderlies wheeled the soldier up the tunnel and into an ambulance. The vehicle was stationed under a shrub. The patient and the other military members were transferred to the city of Dnipro for further treatment. The underground hospital staff took a break. The hospital’s orange feline, the mascot, walked toward the entrance to await the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”