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Sparse trees conceal the entrance. A sloping timber tunnel leads down to a brightly lit reception area. There is a operating ward, outfitted with gurneys, cardiac monitors and breathing machines. And shelves full of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians keep an eye on a screen. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Hospital personnel at an underground hospital observe a monitor displaying Russian suicide and reconnaissance UAVs in the area.

This is the nation's covert below-ground hospital. The facility 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. “Our facility sits 6 metres below the earth. It’s the most secure method of providing help to our injured soldiers. And it keeps medical personnel protected,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 casualties a day. Their conditions vary. Some have devastating leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the victims of enemy FPV drones, which drop explosives with lethal accuracy. “90% of our patients are from first-person view drones. We encounter minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor said.

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

On one day recently, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV explosion had torn a small hole in his limb. “War is horrific. The guy next to me, Vasyl, was killed,” he stated. “He fell down. Subsequently the Russians released a another explosive on him.” He added: “All structures in the settlement is destroyed. There are drones all around and casualties. Our side's and theirs.”

Dvorskyi explained his squad spent over a month in a forest area near Pokrovsk, which Russia has been trying to seize since last year. The only way to reach their location was on foot. Necessary provisions arrived by drone: rations and water. A week after he was injured, he traveled 5km (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his vital signs. Following care, a medical attendant gave him fresh non-military attire: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a FPV drone caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in concussion. “My position was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he said. “I think I was fortunate to remain alive. My cousin has been lost. There are continuous explosions.” A builder working in Lithuania, Filipchuk said he had come back to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the upper body. He expressed pain as medical staff placed him on a bed, took off a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to ring his sister. “A fragment of mortar struck me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. That will take a few months. After that, to go back to my military group. Someone must protect our country,” he said.

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

Over the past years, enemy forces has repeatedly targeted medical centers, health facilities, obstetric units and ambulances. Per human rights groups, 261 health workers have been fatally attacked in almost two thousand assaults. The underground facility is constructed from four steel bunkers, with timber beams, earth and sand placed above reaching ground level. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges dropped by aerial means.

The Ukrainian steel and mining company, which funded the construction, plans to build 20 units in all. The head of Ukraine’s national security council and former military leader, Rustem Umerov, said they would be “critically important for preserving the lives of our armed forces and assisting troops on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, explained some wounded personnel had to endure delays hours or even multiple days before they could be transported due to the danger of aerial attacks. “We had a pair of severely injured casualties who came at 3am. It was necessary to perform a removal of both limbs on one of them. His tourniquet had been applied for such an extended period there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Orderlies wheeled the soldier through the passage and into an ambulance. The transport was stationed beneath a bush. The patient and the two other soldiers were transferred to the urban center of Dnipro for additional medical care. The subterranean medical team paused for rest. The hospital’s ginger cat, the mascot, padded toward the doorway to await the incoming patients. “We are active around the clock,” the surgeon stated. “The work is continuous.”