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Sparse trees conceal the entryway. One sloping wooden tunnel descends to a well-illuminated reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And shelves stocked of medical equipment, medications and organized stacks of extra garments. In a break area with a washing machine and kettle, doctors monitor a screen. It shows the flight patterns of Russian spy drones as they weave in the air above.

Hospital personnel at an underground medical center observe a monitor displaying Russian suicide and reconnaissance UAVs in the region.

This is Ukraine’s secret below-ground hospital. The facility opened in the eighth month and is the second of its kind, located in the eastern part of the country close to the frontline and the city of Pokrovsk in the Donetsk region. “We are six meters below the earth. This is the most secure method of delivering care to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have devastating leg injuries requiring amputations, or serious abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy FPV drones, which release grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We encounter few gunshot wounds. It’s an era of unmanned aircraft and a new type of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in the eastern region.

On one day recently, three military members walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an FPV explosion had ripped a small hole in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a second grenade on him.” He continued: “All structures in the settlement is demolished. We see drones everywhere and casualties. Ours and theirs.”

The soldier explained his squad endured over a month in a forest area close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their position was by walking. Necessary provisions arrived by drone: rations and water. A week following he was hurt, he traveled 5km (about 3 miles), requiring three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a set of pale denim trousers.

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

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. There are continuous detonations.” A construction worker employed in Lithuania, Filipchuk noted he had come back to Ukraine and enlisted to serve shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as medical staff laid him on a medical cot, took off a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of artillery hit me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. This may require a few months. After that, to go back to my military group. Someone has to protect our country,” he said.

Doctors treat the wounded soldier, who was hit in the back by a piece of mortar.

Over the past years, Russia has consistently targeted medical centers, clinics, maternity wards and ambulances. Per international monitors, 261 medical personnel have been killed in nearly 2,000 attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and sand laid on top up to the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple eight-kilogram explosive devices dropped by drone.

The Ukrainian steel and mining company, which financed the construction, intends to build twenty facilities in all. The head of Ukraine’s national security council and ex- defence minister, the official, declared they would be “critically important for saving the survival of our military and assisting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken after the enemy's military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said some injured personnel had to endure delays many hours or even multiple days before they could be transported due to the threat of aerial attacks. “Our facility received a pair of severely injured casualties who came at the early hours. I had to perform a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no other option.” How did he cope with traumatic surgeries? “My career in healthcare for two decades. One must focus,” he remarked.

Orderlies transported Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the other military members were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, walked up to the entrance to await the next arrivals. “Our facility operates active around the clock,” the surgeon said. “It doesn’t stop.”