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Scrubby foliage hide the entrance. A sloping timber tunnel leads down to a brightly lit reception area. There is a operating ward, equipped with gurneys, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, medications and organized stacks of extra garments. Within a break area with a washing machine and hot water heater, physicians keep an eye on a display. It shows the flight patterns of Russian spy drones as they zigzag in the air above.

Medical staff at an underground medical center look at a screen showing enemy suicide and surveillance drones in the area.

This is Ukraine’s secret below-ground hospital. The facility began operations in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the earth. This is the safest method of providing help to our wounded military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Their conditions vary. Some have catastrophic leg injuries necessitating amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our patients are from FPVs. We see minimal gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the surgeon explained.

Major 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 limped into the facility. The most lightly injured, 28-year-old one soldier, said an FPV blast had torn a small hole in his limb. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces released a another grenade on him.” He added: “All structures in the settlement is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

The soldier said his squad endured over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their position was on foot. Necessary provisions arrived by drone: food and water. A week after he was injured, he walked five kilometers (roughly three miles), taking three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him new non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, 28, stated a FPV aerial device ripped a minor injury in his leg.

Another patient, 38-year-old a serviceman, said a drone blast had resulted in concussion. “My position was in a dugout. It suddenly went dark. I couldn’t feel any feeling or any sound,” he explained. “I think I was fortunate to remain alive. My cousin has been killed. We face continuous explosions.” A construction worker working in a neighboring country, he said he had returned to his homeland and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a medical cot, took off a bloody bandage and treated his two-day-old injury from fragments. Covered in a foil blanket, he borrowed a mobile phone to call his family member. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my military group. Someone must protect our country,” he said.

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

Since 2022, Russia has consistently attacked hospitals, health facilities, obstetric units and emergency vehicles. According to international monitors, 261 health workers have been fatally attacked in nearly 2,000 attacks. The underground facility is built from four steel bunkers, with timber beams, earth and granular material laid on top up to ground level. It is designed to resist impacts from 152mm projectiles and even multiple eight-kilogram TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, intends to erect twenty units in all. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our military and assisting defenders on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had undertaken after the enemy's military offensive.

An example of the centre’s surgical rooms.

The surgeon, said certain wounded personnel had to endure delays many hours or even multiple days before they could be evacuated due to the danger of air assaults. “Our facility received two severely injured patients who arrived at the early hours. It was necessary to perform a removal of both limbs on a patient. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with traumatic operations? “My career in medicine for 20 years. One must concentrate,” he remarked.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The transport was parked beneath a bush. The patient and the other soldiers were transferred to the urban center of a major city for further treatment. The underground medical team took a break. The facility's orange feline, the mascot, walked up to the entrance to await the incoming patients. “We are open around the clock,” the surgeon said. “The work is continuous.”