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Sparse foliage hide the entrance. A sloping wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets stocked of medical equipment, medications and organized stacks of spare clothes. In a staff room with a laundry appliance and kettle, doctors keep an eye on a screen. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground hospital look at a monitor displaying Russian kamikaze and reconnaissance drones in the region.

This is Ukraine’s secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, situated in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “We are six meters under the earth. It’s the most secure way of delivering care to our wounded military personnel. And it keeps medical personnel protected,” stated the clinic’s lead doctor, Major the chief surgeon.

This medical station treats 30-40 patients a day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring surgical removal, or serious abdominal injuries. Some patients can walk. The vast majority are the victims of enemy first-person view (FPV) drones, which drop grenades with deadly accuracy. “90% of our cases are from FPVs. We encounter few bullet injuries. It’s an age of drones and a different kind of war,” the surgeon explained.

Maj the senior surgeon at the subterranean installation for treating wounded soldiers in eastern Ukraine.

During one day recently, three military members walked with difficulty into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a small hole in his limb. “War is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He collapsed. Subsequently the enemy forces released a another explosive on him.” He added: “Everything in the settlement is destroyed. We see drones all around and bodies. Our side's and theirs.”

The soldier said his unit spent over a month in a forest area close to Pokrovsk, which enemy forces has been attempting to capture since last year. The only way to reach their location was on foot. Necessary provisions arrived by quadcopter: food and drinking water. Seven days after he was injured, he walked five kilometers (about 3 miles), requiring several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view drone caused a minor injury in his leg.

A different casualty, 38-year-old a serviceman, recounted a drone blast had left him with a head injury. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I believe I was lucky to remain alive. My cousin has been killed. There are ongoing detonations.” A builder working in a neighboring country, Filipchuk said he had returned to Ukraine and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the upper body. He expressed pain as doctors laid him on a bed, removed a bloody dressing and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a cellphone to ring his sister. “A fragment of mortar struck me. The cause was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To get better. This may require a few months. After that, to return to my unit. Someone has to protect our country,” he said.

Medical staff care for the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently attacked hospitals, clinics, maternity wards and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in nearly two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, soil and granular material laid on top reaching ground level. It can withstand impacts from 152mm artillery shells and even three 8kg TNT charges dropped by aerial means.

The Ukrainian industrial group, which financed the building, plans to erect twenty facilities in total. The head of the nation's national security council and ex- defence minister, Rustem Umerov, said they would be “vitally important for preserving the lives of our armed forces and assisting defenders on the frontline.” The organization described the project as the “largest-scale and demanding” it had undertaken since Russia’s invasion.

An example of the centre’s surgical rooms.

The surgeon, said some injured personnel had to wait hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of critically ill patients who arrived at the early hours. I had to carry out a double amputation on one of them. His tourniquet had been applied for so long there was no other option.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Medical assistants transported Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other military members were transferred to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded up to the entrance to await the incoming patients. “We are open around the clock,” the surgeon said. “It doesn’t stop.”