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Sparse trees hide the entrance. A descending timber passageway leads down to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. Plus shelves full of medical equipment, medications and neat piles of extra garments. Within a staff room with a washing machine and kettle, physicians keep an eye on a display. The screen reveals the movements of enemy spy drones as they zigzag in the sky above.

Medical personnel at an underground medical center look at a monitor displaying Russian kamikaze and reconnaissance UAVs in the area.

This is Ukraine’s secret below-ground hospital. This center opened in the eighth month and is the second of its kind, situated in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. It’s the most secure method of providing help to our wounded military personnel. It also ensures healthcare workers safe,” stated the facility's lead doctor, Major the chief surgeon.

This medical station handles thirty to forty patients a each day. Cases differ widely. Certain individuals suffer from devastating limb trauma 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 release explosives with lethal precision. “90% of our cases are from FPVs. We see minimal bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground facility for treating wounded soldiers in eastern Ukraine.

On one afternoon last week, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his leg. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Then the Russians dropped a another grenade on him.” He added: “Everything in the village is demolished. There are drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad spent 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to reach 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), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff checked his vital signs. Following care, a nurse provided him with fresh non-military attire: a T-shirt and a set of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device caused a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly became black. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. My cousin has been killed. We face ongoing explosions.” A construction worker working in a neighboring country, he noted he had come back to his homeland and enlisted to fight days before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as doctors laid him on a bed, removed a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A fragment of artillery struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To recover. This may require a few months. After that, to return to my unit. Our forces must defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Since 2022, enemy forces has consistently targeted medical centers, clinics, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been killed in nearly two thousand attacks. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and sand laid on top reaching ground level. It is designed to resist impacts from large-caliber artillery shells and even three eight-kilogram TNT charges released by aerial means.

A major industrial group, which funded the building, plans to build twenty units in all. A senior official of Ukraine’s security agency and former military leader, the official, declared they would be “critically essential for preserving the survival of our armed forces and assisting defenders on the battlefront.” The company referred to the project as the “most ambitious and demanding” it had implemented since the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, said certain injured personnel had to wait many hours or even days before they could be evacuated due to the danger of aerial attacks. “We had two critically ill casualties who came at the early hours. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been on for such an extended period there was no other option.” How did he cope with severe operations? “My career in healthcare for two decades. One must focus,” he said.

Medical assistants transported the soldier through the tunnel and into an ambulance. The transport was parked beneath a bush. He and the other soldiers were transferred to the city of Dnipro for further treatment. The underground hospital staff took a break. The hospital’s ginger cat, the mascot, walked toward the entrance to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”