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Sparse trees conceal the entryway. A sloping timber tunnel descends to a brightly lit reception area. There is a operating ward, outfitted with beds, heart rate sensors and ventilators. And shelves full of medical equipment, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians monitor a display. It shows the movements of Russian spy drones as they weave in the sky above.

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

This is Ukraine’s covert underground hospital. This center began operations in August and is the second of its kind, situated in the eastern part of the country not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits six meters below the earth. It’s the safest way of delivering care to our wounded military personnel. And it keeps medical personnel protected,” stated the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 patients a each day. Their conditions vary. Certain individuals suffer from devastating limb trauma requiring surgical removal, or serious abdominal injuries. Others can move on their own. Almost all are the casualties of enemy FPV drones, which release explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We encounter few bullet injuries. This is an era of unmanned aircraft and a new type of war,” the surgeon said.

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

On one day recently, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is destroyed. We see drones all around and casualties. Ours and theirs.”

Dvorskyi said his squad endured 43 days in a wooded zone close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their position was on foot. All supplies arrived by drone: rations and water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to where an military transport was able to pick him up. At the clinic, a medic checked his physical condition. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, said a first-person view aerial device ripped a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in concussion. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been killed. We face ongoing detonations.” A builder working in a neighboring country, Filipchuk noted he had come back to his homeland and volunteered to fight days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as medical staff placed him on a bed, removed a stained bandage and cleaned his two-day-old shrapnel wound. Wrapped in a thermal sheet, he used a mobile phone to ring his sister. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. This may require a several months. After that, to go back to my unit. Our forces must protect our nation,” he affirmed.

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

Over the past years, Russia has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been fatally attacked in nearly 2,000 assaults. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material laid on top reaching the surface. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges released by aerial means.

The Ukrainian steel and mining company, which funded the construction, intends to build twenty units in total. A senior official of the nation's security agency and ex- military leader, Rustem Umerov, said they would be “vitally essential for preserving the lives of our armed forces and assisting defenders on the frontline.” The organization described the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, explained some injured personnel had to wait hours or even multiple days before they could be transported because of the danger of air assaults. “We had two severely injured patients who came at 3am. I had to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with severe surgeries? “I’ve been healthcare for two decades. One must concentrate,” he said.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The transport was parked under a shrub. The patient and the other soldiers were taken to the urban center of Dnipro for further treatment. The subterranean hospital staff took a break. The hospital’s orange feline, the mascot, padded up to the entrance to await the next arrivals. “We are open around the clock,” the surgeon stated. “The work is continuous.”