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Scrubby trees conceal the entryway. A descending timber passageway leads down to a well-illuminated welcome zone. Inside lies a surgery unit, equipped with gurneys, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, medications and organized stacks of extra garments. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the movements of Russian spy drones as they zigzag in the sky above.

Hospital personnel at an subterranean hospital look at a monitor displaying Russian kamikaze and surveillance drones in the area.

Welcome to the nation's secret underground hospital. This center began operations in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “We are 6 metres under the ground. This is the safest method of providing help to our injured military personnel. It also ensures healthcare workers protected,” stated the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a each day. Their conditions vary. Some have devastating limb trauma necessitating amputations, or severe stomach wounds. Others can walk. The vast majority are the casualties of Russian FPV drones, which drop explosives with deadly accuracy. “90% of our cases are from first-person view drones. We see few bullet injuries. It’s an era of unmanned aircraft and a new type of conflict,” the doctor said.

Major the senior surgeon at the underground installation for treating wounded troops in eastern Ukraine.

During one day recently, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone explosion had torn a small hole in his leg. “Conflict is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He fell down. Then the Russians dropped a second explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs everywhere and bodies. Ours and theirs.”

Dvorskyi said his unit endured 43 days in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to get to their location was on foot. All supplies arrived by drone: rations and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), requiring several hours, to where an military transport was able to pick him up. Upon arrival, a medic checked his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a set of light-colored denim trousers.

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

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “I was in a dugout. Suddenly it went dark. I lost sensation anything or any sound,” he explained. “I believe I was fortunate to remain alive. A relative has been killed. There are ongoing detonations.” A construction worker working in a neighboring country, Filipchuk said he had returned to Ukraine and volunteered to serve days before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He expressed pain as doctors laid him on a medical cot, removed a stained bandage and treated his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. Subsequently, to return to my unit. Our forces must defend our nation,” he affirmed.

Doctors treat the wounded soldier, who was hit in the back by a piece of artillery shell.

Since 2022, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. According to human rights groups, 261 medical personnel have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, soil and sand laid on top reaching ground level. It can withstand impacts from large-caliber projectiles and even three 8kg TNT charges released by aerial means.

A major industrial group, which financed the building, plans to build 20 facilities in total. The head of the nation's national security council and former military leader, Rustem Umerov, said they would be “critically important for preserving the survival of our military and supporting troops on the frontline.” The organization described the project as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

An example of the centre’s surgical rooms.

Holovashchenko, said some injured personnel had to endure delays many hours or even multiple days before they could be transported because of the danger of air assaults. “We had a pair of critically ill casualties who came at 3am. I had to perform a double amputation on a patient. His tourniquet had been applied for so long there was no other option.” What is his method with traumatic surgeries? “My career in medicine for 20 years. You have to focus,” he said.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The vehicle was parked under a shrub. He and the other soldiers were transferred to the city of Dnipro for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, the mascot, padded up to the entrance to await the incoming patients. “We are open 24 hours a day,” the surgeon stated. “The work is continuous.”