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Scrubby trees conceal the entrance. One sloping wooden passageway leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets full of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a washing machine and kettle, physicians keep an eye on a screen. The screen reveals the flight patterns of enemy spy drones as they weave in the air above.

Hospital staff at an subterranean hospital look at a monitor displaying Russian suicide and reconnaissance UAVs in the region.

This is Ukraine’s secret below-ground hospital. The facility began operations in the eighth month and is the second such installation, situated in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are six meters under the earth. This is the most secure method of providing help to our injured soldiers. And it keeps healthcare workers protected,” said the facility's lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We encounter few bullet injuries. It’s an era of drones and a new type of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean facility for caring for wounded troops in eastern Ukraine.

On one afternoon recently, three soldiers limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an first-person view drone blast had torn a small hole in his leg. “War is terrible. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the enemy forces dropped a second grenade on him.” He continued: “Everything in the village is destroyed. There are UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his squad endured over a month in a wooded zone close to Pokrovsk, which Russia has been attempting to capture for many months. Sole access to get to their position was on foot. Necessary provisions arrived by quadcopter: food and drinking water. Seven days following he was injured, he traveled 5km (about 3 miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his physical condition. Following care, a nurse gave him new non-military attire: a T-shirt and a set of light-colored jeans.

The soldier, 28, said a FPV drone caused a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, said a drone blast had left him with concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to remain alive. My cousin has been killed. We face ongoing explosions.” A builder working in Lithuania, he said he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He groaned as doctors laid him on a medical cot, took off a stained bandage and cleaned his recent shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to ring his family member. “A piece of mortar hit me. It was a ricochet. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to go back to my unit. Someone has to protect our nation,” he said.

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

Over the past years, enemy forces has consistently targeted hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 medical personnel have been fatally attacked in almost two thousand assaults. The underground facility is built from multiple reinforced shelters, with timber beams, earth and sand laid on top up to ground level. It can withstand direct hits from 152mm artillery shells and even multiple eight-kilogram TNT charges released by drone.

The Ukrainian industrial group, which funded the construction, intends to build 20 facilities in all. A senior official of Ukraine’s security agency and ex- defence minister, the official, declared they would be “critically important for saving the survival of our military and assisting defenders on the frontline.” The company described the project as the “most ambitious and demanding” it had undertaken since the enemy's invasion.

An example of the facility's surgical rooms.

Holovashchenko, explained certain wounded personnel had to wait many hours or even multiple days before they could be transported due to the danger of aerial attacks. “We had a pair of severely injured casualties who arrived at the early hours. It was necessary to carry out a removal of both limbs on one of them. The soldier's tourniquet had been on for so long there was no other option.” What is his method with traumatic surgeries? “My career in medicine for 20 years. One must focus,” he said.

Orderlies wheeled the soldier through the passage and into an ambulance. The transport was stationed beneath a shrub. The patient and the two other soldiers were transferred to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The facility's ginger cat, the mascot, walked up to the doorway to await the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”