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Sparse foliage hide the entryway. A sloping timber tunnel descends to a brightly lit reception area. There is a operating ward, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, physicians monitor a screen. It shows the movements of Russian spy drones as they weave in the air above.

Hospital staff at an underground medical center look at a monitor showing enemy kamikaze and surveillance UAVs in the area.

This is the nation's covert below-ground hospital. This center opened in August and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “Our facility sits 6 metres below the earth. This is the safest way of delivering care to our injured military personnel. It also ensures medical personnel safe,” stated the facility's lead doctor, Major the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have devastating leg injuries necessitating amputations, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which drop grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter few bullet injuries. This is an age of unmanned aircraft and a new type of conflict,” the doctor said.

Major Oleksandr Holovashchenko at the underground facility for caring for injured soldiers in the eastern region.

On one afternoon last week, three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, said an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he stated. “He fell down. Subsequently the Russians dropped a another explosive on him.” He continued: “All structures in the settlement is destroyed. There are drones everywhere and bodies. Ours and theirs.”

Dvorskyi explained his squad endured over a month in a wooded zone close to Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies arrived by quadcopter: food and drinking water. A week following he was hurt, he walked 5km (about 3 miles), taking several hours, to a point where an military transport was able to evacuate him. Upon arrival, a medical staff checked his physical condition. After treatment, a medical attendant gave him new civilian clothes: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a FPV drone caused a minor injury in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been killed. There are ongoing explosions.” A construction worker working in a neighboring country, Filipchuk noted he had returned to his homeland and volunteered to fight days before Vladimir Putin’s large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a bloody bandage and cleaned his recent shrapnel wound. Covered in a thermal sheet, he used a cellphone to ring his family member. “A fragment of mortar hit me. The cause was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my military group. Someone must protect our nation,” he affirmed.

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

Over the past years, enemy forces has repeatedly targeted hospitals, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been killed in nearly two thousand attacks. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, earth and granular material laid on top up to ground level. It can withstand direct hits from large-caliber projectiles and even multiple eight-kilogram explosive devices released by drone.

A major industrial group, which funded the building, intends to erect twenty units in total. The head of Ukraine’s national security council and former defence minister, the official, declared they would be “critically essential for saving the lives of our armed forces and assisting troops on the frontline.” The company referred to the initiative as the “largest-scale and demanding” it had implemented after Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, explained certain wounded soldiers had to endure delays many hours or even days before they could be evacuated because of the threat of air assaults. “Our facility received a pair of severely injured casualties who came at 3am. It was necessary to carry out a double amputation on a patient. His tourniquet had been applied for so long there was no other option.” How did he cope with traumatic surgeries? “My career in medicine for 20 years. You have to focus,” he said.

Orderlies wheeled the soldier up the passage and into an ambulance. The vehicle was parked beneath a shrub. He and the two other soldiers were taken to the city of Dnipro for further treatment. The subterranean hospital staff took a break. The facility's orange feline, the mascot, walked up to the entrance to greet the incoming patients. “We are active 24 hours a day,” Holovashchenko said. “The work is continuous.”