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Scrubby foliage hide the entryway. A sloping wooden tunnel descends to a well-illuminated reception area. There is a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, drugs and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the sky above.

Medical personnel at an underground hospital observe a monitor displaying enemy suicide and surveillance drones in the area.

Welcome to the nation's secret underground hospital. This center opened 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 Donetsk oblast. “We are 6 metres below the ground. It’s the most secure way of delivering care to our injured military personnel. It also ensures healthcare workers safe,” stated the facility's surgeon, Major Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a day. Their conditions vary. Some have devastating limb trauma requiring amputations, or severe stomach wounds. Others can move on their own. The vast majority are the victims of enemy FPV aerial devices, which release grenades with lethal precision. “90% of our patients are from FPVs. We see minimal gunshot wounds. This is an era of unmanned aircraft and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded soldiers in the eastern region.

During one day recently, a group of three military members limped into the facility. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his leg. “War is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “Everything in the settlement is destroyed. We see drones all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his unit spent 43 days in a wooded zone close to the city, which enemy forces has been attempting to capture since last year. The only way to get to their location was on foot. Necessary provisions arrived by drone: rations and drinking water. A week following he was hurt, he walked five kilometers (about 3 miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, said a first-person view drone ripped a small hole in his leg.

Another patient, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to survive. A relative has been killed. We face ongoing explosions.” A construction worker employed in Lithuania, Filipchuk said he had returned to his homeland and volunteered to serve shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors laid him on a medical cot, took off a stained dressing and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he used a cellphone to call his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What were his plans now? “To get better. That will take a few months. After that, to return to my unit. Our forces has to protect our country,” he said.

Doctors care for the wounded soldier, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, enemy forces has repeatedly targeted medical centers, health facilities, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in almost two thousand assaults. The underground facility is built from four steel bunkers, with timber beams, soil and granular material laid on top reaching the surface. It can withstand impacts from 152mm projectiles and even three 8kg TNT charges released by aerial means.

A major steel and mining company, which financed the building, plans to erect twenty units in total. A senior official of Ukraine’s national security council and ex- defence minister, the official, declared they would be “vitally essential for preserving the lives of our armed forces and supporting defenders on the frontline.” The organization referred to the initiative as the “most ambitious and challenging” it had implemented after the enemy's military offensive.

An example of the facility's operating theatres.

Holovashchenko, said certain injured personnel had to endure delays many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “Our facility received a pair of severely injured 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 so long there was no alternative.” What is his method with severe operations? “My career in medicine for 20 years. One must focus,” he said.

Orderlies transported Mykolaichuk through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a bush. The patient and the two other soldiers were transferred to the city of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s orange feline, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”