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Sparse trees conceal the entrance. One sloping timber tunnel descends to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets full of medical equipment, medications and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, doctors keep an eye on a screen. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Hospital staff at an subterranean hospital look at a monitor displaying Russian kamikaze and surveillance 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 frontline and the urban area of Pokrovsk in the Donetsk region. “We are six meters below the ground. It’s the most secure method of providing help to our wounded military personnel. It also ensures healthcare workers protected,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a day. Their conditions vary. Some have devastating limb trauma requiring amputations, or severe abdominal injuries. Others can walk. The vast majority are the victims of Russian first-person view (FPV) drones, which release grenades with lethal precision. “90% of our patients are from FPVs. We encounter minimal bullet injuries. It’s an age of drones and a different kind of war,” the surgeon said.

Major the senior surgeon at the underground installation for treating wounded troops in the eastern region.

During one afternoon recently, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a small hole in his leg. “War is terrible. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the enemy forces released a second explosive on him.” He continued: “Everything in the settlement is demolished. There are drones everywhere and casualties. Our side's and theirs.”

The soldier said his unit spent 43 days in a wooded zone close to Pokrovsk, which Russia has been trying to seize since last year. The only way to get to their location was by walking. Necessary provisions came by drone: food and drinking water. Seven days after he was injured, he traveled 5km (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 physical condition. After treatment, a nurse provided him with new non-military attire: a shirt and a pair of pale jeans.

Artem Dvorskiy, twenty-eight, stated a first-person view drone caused a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, said a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or any sound,” he explained. “I believe I was lucky to survive. A relative has been lost. We face continuous detonations.” A builder employed in Lithuania, he noted he had come back to his homeland and volunteered to fight shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as doctors laid him on a bed, removed a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A piece of artillery hit me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. That will take a few months. After that, to return to my military group. Our forces must protect our country,” he affirmed.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted hospitals, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in nearly 2,000 attacks. This subterranean hospital is built from four steel bunkers, with timber beams, earth and granular material laid on top up to the surface. It can withstand direct hits from large-caliber artillery shells and even multiple 8kg TNT charges released by aerial means.

A major steel and mining company, which funded the construction, plans to erect twenty units in total. A senior official of Ukraine’s national security council and former military leader, the official, said they would be “vitally important for saving the lives of our military and supporting defenders on the battlefront.” The organization described the initiative as the “largest-scale and challenging” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

Holovashchenko, said certain injured personnel had to wait hours or even days before they could be evacuated because of the threat of aerial attacks. “We had a pair of severely injured patients who arrived at the early hours. I had to perform a removal of both limbs on a patient. His bleeding control device had been on for so long there was no other option.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. One must focus,” he remarked.

Medical assistants wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The vehicle was stationed beneath a shrub. The patient and the other military members were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s ginger cat, the mascot, walked toward the doorway to greet the incoming patients. “We are active 24 hours a day,” the surgeon stated. “It doesn’t stop.”