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Scrubby trees conceal the entryway. One descending wooden tunnel descends to a well-illuminated reception area. There is a operating ward, equipped with beds, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, medications and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Medical personnel at an underground medical center look at a monitor showing enemy kamikaze and reconnaissance drones in the area.

This is the nation's covert underground hospital. This center opened in August and is the second such installation, situated 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 6 metres under the ground. This is the safest way of providing help to our wounded military personnel. And it keeps healthcare workers protected,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from FPVs. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the underground facility for treating injured troops in the eastern region.

On one afternoon last week, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an first-person view drone explosion had torn a small hole in his leg. “Conflict is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a another grenade on him.” He continued: “Everything in the village is demolished. There are UAVs everywhere and bodies. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a wooded zone near the city, which Russia has been attempting to capture for many months. Sole access to reach their location was on foot. All supplies came by drone: food and drinking water. A week following he was hurt, he traveled five kilometers (roughly three miles), requiring three hours, to where an military transport was able to pick him up. Upon arrival, a medical staff checked his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a T-shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, said a FPV aerial device caused a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was lucky to remain alive. A relative has been lost. We face ongoing detonations.” A builder working in a neighboring country, he noted he had come back to Ukraine and volunteered to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the back. He groaned as medical staff placed him on a bed, took off a bloody dressing and treated his recent injury from fragments. Covered in a foil blanket, he borrowed a cellphone to call his sister. “A piece of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. That will take a several months. Subsequently, to return to my military group. Our forces has to defend our nation,” he said.

Doctors treat Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Over the past years, Russia has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. According to human rights groups, 261 health workers have been killed in nearly two thousand attacks. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple eight-kilogram TNT charges dropped by aerial means.

A major industrial group, which financed the construction, plans to build 20 facilities in total. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “critically important for saving the survival of our armed forces and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, explained some injured personnel had to wait many hours or even days before they could be evacuated because of the threat of air assaults. “We had two severely injured casualties who came at the early hours. It was necessary to carry out a double amputation on a patient. His tourniquet had been on for such an extended period there was no alternative.” What is his method with severe operations? “My career in medicine for two decades. You have to concentrate,” he remarked.

Medical assistants wheeled the soldier up the passage and into an emergency vehicle. The transport was parked beneath a shrub. The patient and the two other soldiers were taken to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, Vasilevs, walked toward the doorway to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon said. “The work is continuous.”