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Sparse trees conceal the entryway. One descending timber tunnel leads down to a brightly lit welcome zone. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. And shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a laundry appliance and kettle, doctors keep an eye on a screen. It shows the movements of Russian spy drones as they weave in the air above.

Medical staff at an underground hospital observe a monitor displaying enemy kamikaze and surveillance UAVs in the region.

This is Ukraine’s covert underground hospital. This center opened in August and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters under the earth. This is the safest way of delivering care to our injured military personnel. It also ensures medical personnel safe,” stated the facility's surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 casualties a each day. Their conditions vary. Some have devastating leg injuries requiring surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which release grenades with deadly precision. “Ninety per cent of our cases are from first-person view drones. We see minimal gunshot wounds. This is an age of drones and a different kind of war,” the doctor said.

Maj Oleksandr Holovashchenko at the underground installation for treating injured soldiers in the eastern region.

On one day last week, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, said an FPV blast had ripped a minor wound in his limb. “War is terrible. The guy next to me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the Russians released a another grenade on him.” He continued: “Everything in the settlement is demolished. We see drones all around and casualties. Our side's and theirs.”

The soldier said his unit spent over a month in a forest area near Pokrovsk, which Russia has been trying to seize for many months. Sole access to reach their position was by walking. All supplies arrived by quadcopter: food and water. A week following he was injured, he walked 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. After treatment, a nurse gave him fresh non-military attire: a shirt and a set of pale denim trousers.

The soldier, 28, stated a first-person view drone caused a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in a head injury. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel anything or hear anything,” he said. “I think I was fortunate to remain alive. A relative has been lost. We face ongoing explosions.” A construction worker employed in Lithuania, Filipchuk noted he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors placed him on a bed, took off a bloody dressing and treated his recent shrapnel wound. Covered in a foil blanket, he used a cellphone to call his sister. “A piece of artillery hit 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. Subsequently, to return to my unit. Someone has to protect our nation,” he said.

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

Since 2022, Russia has consistently targeted 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 attacks. The underground facility is constructed from four reinforced shelters, with timber beams, earth and granular material laid on top reaching the surface. It can withstand direct hits from large-caliber artillery shells and even three 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to erect 20 facilities in all. The head of the nation's national security council and former defence minister, the official, said they would be “critically essential for saving the survival of our military and assisting defenders on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken after Russia’s military offensive.

One of the facility's surgical rooms.

The surgeon, said certain injured personnel had to wait many hours or even days before they could be evacuated due to the danger of aerial attacks. “We had two severely injured patients who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for so long there was no alternative.” How did he cope with severe operations? “My career in healthcare for two decades. One must focus,” he remarked.

Medical assistants wheeled the soldier up the tunnel and into an ambulance. The transport was stationed beneath a shrub. The patient and the other soldiers were taken to the urban center of a major city for additional medical care. The underground hospital staff paused for rest. The facility's ginger cat, the mascot, padded up to the doorway to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko stated. “The work is continuous.”