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Scrubby foliage conceal the entrance. A sloping wooden tunnel leads down to a brightly lit reception area. There is a surgery unit, equipped with beds, cardiac monitors and ventilators. And cabinets full of healthcare supplies, drugs and neat piles of extra garments. In a break area with a laundry appliance and kettle, physicians monitor a display. It shows the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital personnel at an subterranean hospital observe a screen displaying Russian kamikaze and surveillance UAVs in the region.

This is the nation's secret below-ground hospital. The facility opened in August and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of a key location in the Donetsk region. “We are 6 metres under the earth. This is the safest method of delivering care to our wounded military personnel. It also ensures medical personnel safe,” stated the facility's surgeon, Maj the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Certain individuals suffer from devastating leg injuries necessitating amputations, or serious stomach wounds. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) drones, which drop explosives with deadly precision. “90% of our cases are from first-person view drones. We see few gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the subterranean installation for treating wounded soldiers in eastern Ukraine.

On one day recently, a group of three soldiers limped into the facility. The most lightly injured, 28-year-old one soldier, reported an FPV explosion had torn a small hole in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a second grenade on him.” He added: “All structures in the village is demolished. There are drones everywhere and bodies. Ours and the enemy's.”

The soldier explained his unit endured over a month in a forest area near the city, which Russia has been attempting to capture since last year. The only way to get to their location was on foot. All supplies came by drone: rations and water. A week after he was injured, he walked 5km (roughly three miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse gave him fresh civilian clothes: a T-shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, said a FPV drone caused a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he explained. “I believe I was fortunate to survive. My cousin has been lost. There are ongoing detonations.” A builder employed in Lithuania, Filipchuk said he had returned to his homeland and volunteered to serve shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He expressed pain as doctors laid him on a medical cot, took off a bloody dressing and treated his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to call his family member. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To get better. That will take a few months. Subsequently, to go back to my unit. Our forces has to defend our nation,” he affirmed.

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

Over the past years, enemy forces has repeatedly attacked hospitals, clinics, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been fatally attacked in nearly two thousand assaults. The underground facility is constructed from four steel bunkers, with timber beams, earth and sand laid on top reaching ground level. It can withstand direct hits from 152mm projectiles and even three eight-kilogram TNT charges dropped by drone.

The Ukrainian steel and mining company, which financed the construction, plans to erect 20 units in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the survival of our military and supporting troops on the frontline.” The company referred to the initiative as the “largest-scale and demanding” it had undertaken since the enemy's invasion.

One of the facility's surgical rooms.

Holovashchenko, said certain injured personnel had to endure delays hours or even multiple days before they could be transported because of the threat of aerial attacks. “We had two severely injured casualties who arrived at 3am. It was necessary to carry out a double amputation on a patient. His bleeding control device had been applied for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. You have to focus,” he remarked.

Medical assistants transported Mykolaichuk through the passage and into an ambulance. The transport was parked beneath a bush. The patient and the two other military members were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, the mascot, padded toward the entrance to await the incoming patients. “We are open 24 hours a day,” the surgeon stated. “The work is continuous.”