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Scrubby foliage conceal the entryway. A descending wooden tunnel descends to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and ventilators. And cabinets stocked of healthcare supplies, drugs and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the movements of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center look at a monitor showing Russian suicide and surveillance UAVs in the area.

Welcome to the nation's secret below-ground hospital. This center began operations in August and is the second such installation, situated in eastern Ukraine close to the frontline and the city of a key location in Donetsk oblast. “We are six meters under the ground. It’s the safest way of delivering care to our injured soldiers. It also ensures medical personnel safe,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have devastating limb trauma necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop explosives with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter few gunshot wounds. It’s an age of drones and a new type of conflict,” the surgeon explained.

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

On one afternoon recently, three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old one soldier, reported an first-person view drone blast had torn a minor wound in his leg. “War is horrific. My comrade beside me, a fellow soldier, was killed,” he said. “He fell down. Then the enemy forces released a second grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs everywhere and bodies. Ours and the enemy's.”

Dvorskyi said his squad spent over a month in a wooded zone near the city, which Russia has been attempting to capture for many months. The only way to reach their position was by walking. All supplies arrived by quadcopter: food and drinking water. Seven days following he was hurt, he walked 5km (roughly three miles), taking three hours, to where an military transport was able to pick him up. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with new civilian clothes: a shirt and a set of pale denim trousers.

The soldier, 28, stated a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “My position was in a dugout. Suddenly it went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was lucky to survive. A relative has been killed. There are ongoing explosions.” A builder employed in Lithuania, Filipchuk noted he had come back to his homeland and enlisted to serve shortly before the Russian leader's large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff laid him on a medical cot, removed a bloody bandage and cleaned his recent injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to call his family member. “A fragment of artillery struck me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. That will take a several months. After that, to return to my unit. Someone must protect our country,” he said.

Doctors care for the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, enemy forces has consistently targeted hospitals, clinics, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been killed in almost two thousand assaults. The underground facility is constructed from four steel bunkers, with wooden supports, earth and sand laid on top reaching ground level. It can withstand direct hits from large-caliber projectiles and even three eight-kilogram TNT charges released by drone.

The Ukrainian steel and mining company, which financed the construction, intends to erect 20 units in total. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “vitally important for preserving the lives of our armed forces and assisting defenders on the frontline.” The company referred to the project as the “largest-scale and challenging” it had implemented since Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, said some wounded soldiers had to wait hours or even days before they could be evacuated because of the threat of air assaults. “We had a pair of severely injured patients who arrived at the early hours. I had to carry out a removal of both limbs on one of them. His bleeding control device had been on for such an extended period there was no alternative.” How did he cope with severe surgeries? “My career in healthcare for two decades. One must focus,” he remarked.

Medical assistants wheeled Mykolaichuk through the passage and into an ambulance. The vehicle was stationed under a shrub. He and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean medical team took a break. The hospital’s ginger cat, Vasilevs, walked up to the entrance to greet the incoming patients. “We are open 24 hours a day,” the surgeon said. “The work is continuous.”