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Scrubby foliage conceal the entryway. A descending timber passageway leads down to a well-illuminated welcome zone. There is a operating ward, equipped with beds, cardiac monitors and breathing machines. Plus shelves stocked of medical equipment, medications and neat piles of extra garments. In a break area with a laundry appliance and kettle, doctors keep an eye on a display. It shows the flight patterns of enemy spy drones as they zigzag in the air above.

Hospital personnel at an subterranean medical center observe a monitor showing enemy kamikaze and surveillance drones in the area.

This is Ukraine’s secret underground hospital. The facility opened in August and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of a key location in the Donetsk region. “We are 6 metres below the ground. It’s the safest way of providing help to our injured military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Others can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release grenades with lethal accuracy. “90% of our patients are from FPVs. We see few bullet injuries. This is an era of unmanned aircraft and a new type of war,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for treating injured soldiers in the eastern region.

During one afternoon last week, a group of three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his leg. “War is terrible. My comrade next to me, Vasyl, was killed,” he said. “He collapsed. Then the enemy forces released a another grenade on him.” He added: “Everything in the settlement is destroyed. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone near Pokrovsk, which Russia has been trying to seize since last year. The only way to get to their position was on foot. Necessary provisions came by drone: rations and drinking water. A week following he was hurt, he traveled 5km (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic checked his vital signs. After treatment, a nurse provided him with new civilian clothes: a T-shirt and a set of pale jeans.

The soldier, twenty-eight, stated a FPV aerial device caused a minor injury in his leg.

A different casualty, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “My position was in a trench shelter. 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. There are continuous detonations.” A builder working in a neighboring country, he noted he had returned to Ukraine and enlisted to fight shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He expressed pain as medical staff laid him on a bed, took off a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call 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 return to my unit. Our forces has to protect our country,” he said.

Doctors care for the wounded soldier, who was hit in the back by a fragment of artillery shell.

Since 2022, Russia has consistently targeted hospitals, clinics, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from four reinforced shelters, with wooden supports, earth and sand laid on top reaching ground level. It can withstand direct hits from 152mm projectiles and even multiple 8kg explosive devices released by aerial means.

A major steel and mining company, which financed the construction, intends to build twenty units in total. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the lives of our military and supporting defenders on the frontline.” The organization described the project as the “most ambitious and challenging” it had implemented after the enemy's military offensive.

One of the centre’s operating theatres.

The surgeon, explained certain injured personnel had to wait many hours or even days before they could be transported due to the danger of air assaults. “We had two severely injured casualties who came at the early hours. I had to perform a removal of both limbs on a patient. His bleeding control device had been on for so long there was no other option.” How did he cope with traumatic surgeries? “My career in healthcare for 20 years. One must concentrate,” he said.

Medical assistants transported the soldier up the tunnel and into an emergency vehicle. The transport was parked beneath a shrub. The patient and the other military members were transferred to the urban center of a major city for further treatment. The subterranean medical team paused for rest. The facility's orange feline, Vasilevs, padded up to the doorway to await the incoming patients. “We are active around the clock,” the surgeon said. “It doesn’t stop.”