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Scrubby trees conceal the entryway. One descending wooden passageway leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. And shelves stocked of medical equipment, drugs and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the movements of Russian surveillance UAVs as they weave in the air above.

Medical personnel at an underground medical center look at a screen showing enemy suicide and reconnaissance drones in the region.

Welcome to the nation's covert underground hospital. This center began operations in the eighth month 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 below the ground. This is the most secure way of providing help to our injured soldiers. It also ensures medical personnel protected,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station treats thirty to forty patients a day. Their conditions vary. Certain individuals suffer from catastrophic leg injuries requiring amputations, or severe stomach wounds. Some patients can walk. The vast majority are the casualties of enemy first-person view (FPV) drones, which drop grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter few bullet injuries. This is an era of drones and a new type of conflict,” the doctor said.

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

On one afternoon last week, a group of three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “Conflict is horrific. The guy next to me, Vasyl, was killed,” he said. “He collapsed. Subsequently the Russians dropped a another explosive on him.” He continued: “All structures in the village is destroyed. There are UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad endured over a month in a wooded zone near the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was by walking. All supplies came by drone: rations and drinking water. A week following he was hurt, he walked 5km (roughly three miles), requiring several hours, to a point where an military transport was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a nurse provided him with fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, 28, stated a FPV drone caused a small hole in his leg.

A different casualty, 38-year-old a serviceman, recounted a drone blast had left him with a head injury. “My position was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he said. “I think I was fortunate to survive. My cousin has been killed. We face ongoing detonations.” A builder working in Lithuania, Filipchuk said he had come back to Ukraine and enlisted to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a bed, took off a stained dressing and treated his recent shrapnel wound. Covered in a thermal sheet, he borrowed a mobile phone to call his family member. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. That will take a few months. After that, to return to my military group. Our forces has to defend our country,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. According to human rights groups, over two hundred health workers have been fatally attacked in almost two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, earth and sand placed above reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple eight-kilogram TNT charges released by aerial means.

The Ukrainian industrial group, which funded the construction, intends to build 20 facilities in all. A senior official of Ukraine’s security agency and ex- defence minister, Rustem Umerov, declared they would be “critically important for saving the survival of our military and supporting troops on the battlefront.” The organization referred to the project as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

One of the centre’s surgical rooms.

Holovashchenko, said some wounded soldiers had to wait hours or even multiple days before they could be transported due to the threat of air assaults. “We had two critically ill casualties who arrived at the early hours. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been on for such an extended period there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. One must concentrate,” he said.

Medical assistants transported Mykolaichuk up the passage and into an emergency vehicle. The transport was parked under a bush. He and the other soldiers were transferred to the urban center of a major city for additional medical care. The subterranean medical team took a break. The hospital’s orange feline, Vasilevs, walked toward the entrance to greet the next arrivals. “We are open around the clock,” the surgeon said. “It doesn’t stop.”