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Sparse trees conceal the entrance. One descending wooden passageway descends to a well-illuminated reception area. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a staff room with a laundry appliance and kettle, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Medical personnel at an underground hospital look at a monitor displaying Russian suicide and reconnaissance drones in the region.

Welcome to the nation's secret below-ground hospital. The facility opened in August and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a each day. Their conditions vary. Some have devastating leg injuries necessitating amputations, or serious stomach wounds. Others can walk. The vast majority are the victims of enemy first-person view (FPV) drones, which release grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We encounter minimal gunshot wounds. This is an era of drones and a new type of war,” the doctor said.

Maj the senior surgeon at the subterranean installation for caring for injured troops in the eastern region.

During one day last week, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was killed,” he said. “He fell down. Then the Russians released a second grenade on him.” He added: “Everything in the settlement is destroyed. We see drones everywhere and casualties. Ours and theirs.”

Dvorskyi said his unit endured over a month in a wooded zone near Pokrovsk, which Russia has been attempting to capture for many months. Sole access to get to their position was on foot. Necessary provisions arrived by drone: food and water. Seven days following he was injured, he traveled five kilometers (about 3 miles), taking several hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his physical condition. After treatment, a nurse gave him new civilian clothes: a T-shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, stated a first-person view aerial device caused a small hole in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “My position was in a dugout. It suddenly went dark. I couldn’t feel any feeling or any sound,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. We face continuous detonations.” A construction worker employed in a neighboring country, he noted he had returned to Ukraine and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, took off a bloody dressing and cleaned his recent injury from fragments. Covered in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of artillery struck 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. Subsequently, to go back to my unit. Someone must protect our country,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a piece of mortar.

Over the past years, Russia has consistently targeted medical centers, clinics, obstetric units and ambulances. Per human rights groups, 261 health workers have been fatally attacked in almost 2,000 attacks. The underground facility is built from four steel bunkers, with timber beams, earth and sand placed above up to ground level. It can withstand impacts from large-caliber projectiles and even multiple 8kg explosive devices released by drone.

The Ukrainian industrial group, which funded the construction, intends to build twenty units in total. A senior official of the nation's security agency and former defence minister, Rustem Umerov, said they would be “vitally essential for preserving the survival of our armed forces and supporting defenders on the battlefront.” The organization referred to the project as the “most ambitious and challenging” it had undertaken after the enemy's military offensive.

An example of the centre’s operating theatres.

The surgeon, said certain wounded soldiers had to wait hours or even multiple days before they could be transported because of the threat of air assaults. “We had two critically ill casualties who came at the early hours. It was necessary to perform a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for two decades. You have to focus,” he said.

Medical assistants transported Mykolaichuk up the tunnel and into an ambulance. The vehicle was stationed under a shrub. The patient and the other military members were taken to the city of a major city for additional medical care. The underground medical team took a break. The hospital’s orange feline, Vasilevs, padded up to the doorway to await the next arrivals. “We are active 24 hours a day,” the surgeon said. “The work is continuous.”