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Sparse trees hide the entryway. A descending wooden tunnel leads down to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. And cabinets full of healthcare supplies, drugs and neat piles of spare clothes. In a break area with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center observe a screen displaying Russian suicide and reconnaissance UAVs in the region.

This is the nation's secret below-ground hospital. This center opened in August and is the second such installation, located in the eastern part of the country close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits six meters under the earth. This is the safest way of delivering care to our wounded military personnel. And it keeps healthcare workers safe,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. Almost all are the casualties of enemy first-person view (FPV) drones, which drop grenades with lethal precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. It’s an age of drones and a different kind of conflict,” the surgeon said.

Maj the senior surgeon at the subterranean installation for treating injured troops in eastern Ukraine.

During one afternoon recently, three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his leg. “Conflict is terrible. The guy beside me, Vasyl, was killed,” he stated. “He collapsed. Then the enemy forces released a second grenade on him.” He added: “Everything in the village is demolished. We see drones all around and bodies. Ours and the enemy's.”

The soldier explained his squad spent over a month in a wooded zone near the city, which Russia has been attempting to capture since last year. Sole access to reach their position was on foot. Necessary provisions arrived by quadcopter: food and drinking water. A week following he was injured, he walked 5km (about 3 miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant gave him new civilian clothes: a shirt and a set of light-colored denim trousers.

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

A different casualty, thirty-eight-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. Suddenly it went dark. I lost sensation anything or hear anything,” he said. “I believe I was lucky to survive. A relative has been killed. We face continuous explosions.” A builder employed in Lithuania, Filipchuk said he had returned to his homeland and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a bed, took off a stained bandage and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a mobile phone to call his sister. “A piece of mortar hit me. The cause was a ricochet. I’m OK,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to return to my unit. Our forces has to defend our nation,” he said.

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

Over the past years, Russia has repeatedly targeted medical centers, health facilities, obstetric units and ambulances. According to human rights groups, 261 health workers have been fatally attacked in nearly two thousand attacks. The underground facility is built from multiple steel bunkers, with timber beams, earth and sand placed above up to ground level. It can withstand direct hits from large-caliber projectiles and even multiple 8kg TNT charges released by aerial means.

A major steel and mining company, which funded the building, plans to build twenty facilities in all. The head of Ukraine’s national security council and ex- military leader, the official, declared they would be “critically important for saving the lives of our military and supporting defenders on the frontline.” The organization described the project as the “largest-scale and challenging” it had undertaken since Russia’s invasion.

An example of the facility's operating theatres.

The surgeon, explained certain wounded soldiers had to endure delays hours or even multiple days before they could be evacuated because of the danger of air assaults. “Our facility received a pair of critically ill patients who came at 3am. I had to perform a double amputation on one of them. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with traumatic surgeries? “My career in medicine for two decades. You have to focus,” he remarked.

Medical assistants wheeled Mykolaichuk up the passage and into an emergency vehicle. The transport was stationed under a bush. He and the other military members were transferred to the urban center of Dnipro for further treatment. The subterranean medical team took a break. The hospital’s orange feline, Vasilevs, padded toward the entrance to await the next arrivals. “We are active around the clock,” Holovashchenko said. “The work is continuous.”