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Scrubby foliage conceal the entrance. One sloping wooden tunnel leads down to a brightly lit welcome zone. Inside lies a operating ward, equipped with gurneys, heart rate sensors and ventilators. Plus cabinets stocked of medical equipment, drugs and organized stacks of spare clothes. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a display. It shows the movements of enemy surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground medical center look at a screen displaying enemy suicide and reconnaissance drones in the area.

Welcome to Ukraine’s covert below-ground hospital. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “We are six meters below the ground. It’s the most secure method of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” stated the clinic’s lead doctor, Major the chief surgeon.

The stabilisation point treats thirty to forty casualties a day. Cases differ widely. Some have catastrophic limb trauma necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of enemy FPV aerial devices, which drop grenades with deadly precision. “Ninety per cent of our cases are from FPVs. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a new type of war,” the surgeon said.

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

On one afternoon last week, three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had ripped a minor wound in his limb. “Conflict is terrible. My comrade beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a second explosive on him.” He added: “All structures in the settlement is demolished. We see UAVs all around and casualties. Our side's and the enemy's.”

Dvorskyi said his squad endured over a month in a forest area close to Pokrovsk, which Russia has been attempting to capture since last year. Sole access to reach their position was on foot. All supplies arrived by drone: rations and water. A week following he was injured, he traveled 5km (about 3 miles), taking three hours, to a point where an military transport was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a nurse gave him fresh civilian clothes: a shirt and a set of pale denim trousers.

Artem Dvorskiy, 28, stated a FPV drone caused a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in a head injury. “I was in a dugout. Suddenly it went dark. I couldn’t feel anything or hear anything,” he explained. “I believe I was fortunate to survive. My cousin has been lost. There are continuous explosions.” A builder employed in Lithuania, Filipchuk noted he had returned to his homeland and volunteered to fight shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as doctors laid him on a bed, took off a bloody dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his sister. “A fragment of artillery struck me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my unit. Someone must defend our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has repeatedly attacked medical centers, clinics, maternity wards and ambulances. According to international monitors, 261 health workers have been fatally attacked in almost 2,000 assaults. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and sand laid on top up to ground level. It can withstand impacts from large-caliber artillery shells and even three 8kg explosive devices dropped by drone.

A major industrial group, which financed the construction, plans to build twenty facilities in all. The head of the nation's national security council and ex- defence minister, the official, said they would be “vitally essential for saving the lives of our armed forces and assisting defenders on the battlefront.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken since the enemy's invasion.

An example of the centre’s operating theatres.

The surgeon, said some injured personnel had to wait many hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received two critically ill patients who came at the early hours. It was necessary to carry out a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no other option.” What is his method with traumatic operations? “My career in healthcare for two decades. One must focus,” he said.

Orderlies transported Mykolaichuk up the passage and into an ambulance. The vehicle was stationed under a bush. The patient and the other military members were transferred to the urban center of a major city for additional medical care. The underground hospital staff paused for rest. The facility's ginger cat, Vasilevs, padded up to the entrance to await the next arrivals. “We are active around the clock,” the surgeon stated. “The work is continuous.”