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Sparse foliage conceal the entrance. A descending timber passageway descends to a brightly lit reception area. There is a surgery unit, outfitted with beds, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, medications and neat piles of extra garments. In a break area with a laundry appliance and hot water heater, physicians keep an eye on a screen. The screen reveals the movements of Russian spy drones as they weave in the sky above.

Medical staff at an subterranean hospital observe a monitor displaying Russian kamikaze and reconnaissance drones in the region.

Welcome to Ukraine’s secret below-ground hospital. This center opened 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 city of Pokrovsk in the Donetsk region. “We are six meters below the earth. This is the most secure way of providing help to our wounded military personnel. It also ensures medical personnel safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from devastating leg injuries necessitating amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the casualties of enemy FPV aerial devices, which release grenades with lethal accuracy. “90% of our patients are from FPVs. We encounter minimal bullet injuries. 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 injured troops in the eastern region.

On one day last week, three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone blast had ripped a minor wound in his leg. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the enemy forces dropped a second explosive on him.” He added: “Everything in the village is destroyed. We see UAVs everywhere and casualties. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days in a forest area near the city, which Russia has been trying to seize for many months. Sole access to get to their location was by walking. Necessary provisions arrived by drone: food and drinking water. Seven days after he was hurt, he traveled 5km (about 3 miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. Following care, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, stated a first-person view aerial device ripped a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly became black. I lost sensation any feeling or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. There are ongoing detonations.” A builder working in a neighboring country, he noted he had come back to Ukraine and volunteered to fight days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, removed a stained bandage and treated his recent injury from fragments. Covered in a thermal sheet, he used a cellphone to ring his family member. “A piece of mortar struck me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To get better. That will take a several months. Subsequently, to go back to my military group. Someone has to defend our nation,” he said.

Medical staff care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly attacked medical centers, clinics, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been killed in nearly 2,000 attacks. The underground facility is constructed from four steel bunkers, with timber beams, soil and sand placed above reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even three eight-kilogram explosive devices released by aerial means.

A major industrial group, which financed the building, intends to build twenty units in total. A senior official of the nation's security agency and former military leader, Rustem Umerov, declared they would be “critically essential for saving the lives of our military and supporting troops on the battlefront.” The organization referred to the initiative as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

An example of the facility's surgical rooms.

The surgeon, said certain wounded soldiers had to wait many hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had two critically ill casualties who came at the early hours. I had to perform a double amputation on a patient. The soldier's tourniquet had been applied for so long there was no alternative.” How did he cope with severe operations? “My career in medicine for two decades. You have to concentrate,” he said.

Medical assistants wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was parked under a bush. The patient and the two other soldiers were transferred to the city of Dnipro for further treatment. The underground hospital staff paused for rest. The facility's ginger cat, the mascot, padded toward the doorway to greet the incoming patients. “We are open 24 hours a day,” Holovashchenko said. “The work is continuous.”