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Scrubby trees hide the entryway. A descending timber passageway descends to a well-illuminated reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and organized stacks of extra garments. In a break area with a laundry appliance and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Medical staff at an subterranean medical center observe a screen displaying enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s covert underground hospital. This center began operations in August and is the second of its kind, located in the eastern part of the country close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are 6 metres under the earth. This is the most secure method of providing help to our wounded soldiers. It also ensures healthcare workers protected,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which release grenades with lethal precision. “90% of our cases are from FPVs. We see few gunshot wounds. This is an age of unmanned aircraft and a different kind of war,” the doctor said.

Major the senior surgeon at the subterranean facility for caring for injured troops in eastern Ukraine.

On one afternoon recently, three military members walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, said an first-person view drone blast had torn a small hole in his limb. “War is horrific. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Then the Russians dropped a second explosive on him.” He continued: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

The soldier said his unit endured over a month in a forest area near Pokrovsk, which Russia has been trying to seize since last year. Sole access to get to their position was on foot. All supplies arrived by quadcopter: rations and drinking water. A week following he was hurt, he walked 5km (about 3 miles), requiring several hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a nurse provided him with new civilian clothes: a shirt and a pair of light-colored denim trousers.

The soldier, 28, said a FPV aerial device ripped a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been killed. There are ongoing detonations.” A construction worker working in Lithuania, Filipchuk said he had come back to Ukraine and enlisted to serve shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, took off a bloody bandage and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to ring his family member. “A piece of mortar hit me. The cause was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my military group. Someone has to defend our country,” he affirmed.

Medical staff treat the wounded soldier, who was injured in the back by a fragment of artillery shell.

Over the past years, Russia has consistently targeted hospitals, health facilities, maternity wards and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, earth and sand laid on top up to the surface. It can withstand direct hits from large-caliber artillery shells and even three 8kg TNT charges dropped by drone.

A major steel and mining company, which funded the building, plans to erect twenty units in all. The head of the nation's national security council and former military leader, Rustem Umerov, said they would be “critically important for saving the lives of our armed forces and supporting defenders on the frontline.” The company described the project as the “largest-scale and demanding” it had undertaken since the enemy's invasion.

An example of the centre’s surgical rooms.

The surgeon, said certain wounded personnel had to wait hours or even days before they could be transported because of the danger of aerial attacks. “Our facility received two severely injured patients who arrived at the early hours. It was necessary to perform a double amputation on one of them. The soldier's tourniquet had been on for such an extended period there was no other option.” What is his method with traumatic surgeries? “My career in healthcare for two decades. One must concentrate,” he remarked.

Orderlies wheeled the soldier up the tunnel and into an ambulance. The vehicle was parked beneath a shrub. The patient and the other soldiers were transferred to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The hospital’s orange feline, Vasilevs, padded up to the entrance to greet the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”