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Sparse trees hide the entrance. A descending wooden passageway leads down to a well-illuminated reception area. Inside lies a operating ward, equipped with gurneys, heart rate sensors and ventilators. And cabinets full of medical equipment, medications and organized stacks of extra garments. Within a break area with a washing machine and kettle, doctors monitor a screen. The screen reveals the movements of Russian spy drones as they weave in the air above.

Hospital personnel at an underground hospital observe a monitor showing Russian kamikaze and surveillance drones in the area.

This is Ukraine’s covert underground medical facility. The facility opened in August and is the second such installation, located in the eastern part of the country not far from the frontline and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. It’s the safest method of providing help to our wounded military personnel. And it keeps healthcare workers safe,” said the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or serious stomach wounds. Others can walk. The vast majority are the victims of enemy FPV aerial devices, which drop explosives with lethal accuracy. “90% of our patients are from first-person view drones. We see few bullet injuries. This is an age of unmanned aircraft and a different kind of war,” the surgeon said.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for injured troops in the eastern region.

During one afternoon recently, a group of three military members walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had torn a minor wound in his limb. “War is horrific. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “All structures in the village is demolished. We see drones everywhere and bodies. Our side's and the enemy's.”

Dvorskyi explained his squad endured over a month in a wooded zone near Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their location was by walking. All supplies arrived by drone: rations and drinking water. Seven days after he was hurt, he walked five kilometers (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his physical condition. After treatment, a medical attendant gave him fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, twenty-eight, stated a FPV aerial device caused a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he explained. “I think I was lucky to survive. My cousin has been lost. There are ongoing detonations.” A builder employed in a neighboring country, Filipchuk noted he had come back to his homeland and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a bed, took off a bloody dressing and treated his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a mobile phone to call his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. That will take a few months. After that, to return to my military group. Our forces must protect our country,” he said.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of mortar.

Since 2022, enemy forces has consistently targeted medical centers, clinics, maternity wards and emergency vehicles. Per international monitors, 261 medical personnel have been fatally attacked in nearly 2,000 attacks. This subterranean hospital is built from multiple steel bunkers, with wooden supports, earth and sand placed above up to ground level. It can withstand impacts from 152mm artillery shells and even three 8kg explosive devices released by drone.

A major steel and mining company, which funded the building, intends to erect twenty facilities in all. A senior official of Ukraine’s national security council and former military leader, the official, declared they would be “vitally important for preserving the survival of our armed forces and supporting defenders on the frontline.” The organization referred to the project as the “most ambitious and demanding” it had undertaken since Russia’s military offensive.

One of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to endure delays many hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had two critically ill patients who came at 3am. I had to carry out a double amputation on a patient. His tourniquet had been on for such an extended period there was no other option.” How did he cope with traumatic operations? “My career in healthcare for 20 years. You have to focus,” he said.

Medical assistants transported Mykolaichuk through the passage and into an emergency vehicle. The transport was parked under a bush. He and the other military members were transferred to the city of a major city for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded toward the doorway to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon said. “It doesn’t stop.”