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Scrubby foliage conceal the entrance. A sloping timber passageway leads down to a brightly lit reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. Plus shelves stocked of healthcare supplies, medications and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Medical staff at an underground medical center look at a monitor showing enemy suicide and reconnaissance drones in the region.

Welcome to the nation's covert below-ground hospital. The facility opened in August and is the second of its kind, situated in eastern Ukraine not far from the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres below the ground. This is the most secure way of providing help to our wounded soldiers. And it keeps healthcare workers safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can walk. Almost all are the casualties of Russian FPV aerial devices, which drop grenades with lethal precision. “Ninety per cent of our patients are from first-person view drones. We see few gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Maj the senior surgeon at the subterranean facility for treating injured soldiers in eastern Ukraine.

During one day last week, three military members walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone blast had ripped a minor wound in his limb. “Conflict is horrific. The guy next to me, a fellow soldier, was killed,” he stated. “He fell down. Then the Russians dropped a another explosive on him.” He continued: “All structures in the village is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

Dvorskyi explained his squad spent over a month in a forest area near the city, which Russia has been trying to seize for many months. The only way to reach their position was by walking. All supplies came by quadcopter: food and drinking water. Seven days following he was hurt, he traveled 5km (roughly three miles), taking three hours, to a point where an military transport was able to pick him up. Upon arrival, a medic assessed his physical condition. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored jeans.

The soldier, 28, said a FPV aerial device caused a minor injury in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face ongoing detonations.” A construction worker working in Lithuania, Filipchuk noted he had returned to Ukraine and volunteered to serve days before the Russian leader's large-scale attack in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff placed him on a bed, removed a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of artillery hit me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. Subsequently, to return to my unit. Our forces must defend our country,” he affirmed.

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

Since 2022, Russia has repeatedly targeted hospitals, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is built from four steel bunkers, with timber beams, earth and sand placed above reaching the surface. It can withstand impacts from 152mm projectiles and even three eight-kilogram explosive devices dropped by aerial means.

A major industrial group, which financed the building, plans to erect 20 units in all. A senior official of Ukraine’s security agency and former defence minister, Rustem Umerov, said they would be “vitally essential for saving the lives of our military and supporting troops on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken since the enemy's military offensive.

One of the facility's surgical rooms.

The surgeon, explained some injured personnel had to endure delays many hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of severely injured casualties who arrived at 3am. I had to perform a double amputation on a patient. The soldier's bleeding control device had been applied for so long there was no other option.” How did he cope with traumatic operations? “I’ve been medicine for 20 years. One must focus,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. He and the other soldiers were transferred to the city of a major city for further treatment. The underground medical team paused for rest. The hospital’s orange feline, the mascot, padded up to the entrance to greet the next arrivals. “We are open around the clock,” the surgeon said. “It doesn’t stop.”