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Sparse trees conceal the entrance. One descending wooden passageway descends to a brightly lit welcome zone. There is a surgery unit, equipped with beds, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and hot water heater, doctors 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 underground medical center look at a monitor showing Russian suicide and reconnaissance UAVs in the region.

Welcome to Ukraine’s secret below-ground hospital. This center began operations in August and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits six meters below the earth. This is the most secure method of delivering care to our injured soldiers. And it keeps medical personnel safe,” said the facility's lead doctor, Maj the chief surgeon.

This medical station handles 30-40 patients a each day. Their conditions vary. Some have catastrophic leg injuries requiring surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the victims of enemy FPV drones, which release explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. This is an age of unmanned aircraft and a different kind of war,” the doctor said.

Maj the senior surgeon at the underground installation for caring for wounded soldiers in the eastern region.

On one afternoon last week, a group of three military members walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, said an FPV blast had ripped a minor wound in his limb. “War is terrible. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the Russians dropped a another grenade on him.” He continued: “Everything in the settlement is destroyed. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit spent 43 days in a forest area close to the city, which Russia has been attempting to capture for many months. The only way to get to their position was by walking. Necessary provisions came by drone: rations and drinking water. Seven days after he was injured, he traveled five kilometers (about 3 miles), taking three hours, to where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant provided him with fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, twenty-eight, stated a first-person view aerial device caused a small hole in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. There are continuous explosions.” A builder employed in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff laid him on a bed, took off a bloody bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to call his family member. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To get better. That will take a several months. After that, to return to my unit. Our forces has to defend our country,” he affirmed.

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

Over the past years, Russia has repeatedly attacked hospitals, clinics, maternity wards and ambulances. According to international monitors, over two hundred medical personnel have been killed in nearly two thousand attacks. The underground facility is built from four reinforced shelters, with wooden supports, earth and granular material laid on top reaching the surface. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg explosive devices released by aerial means.

The Ukrainian steel and mining company, which financed the construction, plans to build twenty units in total. The head of Ukraine’s national security council and ex- defence minister, the official, declared they would be “critically important for preserving the lives of our military and supporting defenders on the frontline.” The company referred to the project as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, said some injured soldiers had to endure delays hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “We had two critically ill patients who arrived at 3am. I had to carry out a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an ambulance. The transport was stationed beneath a bush. He and the other military members were transferred to the city of a major city for additional medical care. The underground medical team took a break. The hospital’s orange feline, the mascot, walked up to the entrance to greet the incoming patients. “Our facility operates open around the clock,” the surgeon said. “The work is continuous.”