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Scrubby foliage conceal the entrance. One descending wooden tunnel leads down to a well-illuminated reception area. There is a surgery unit, equipped with beds, heart rate sensors and ventilators. And shelves stocked of medical equipment, drugs and neat piles of extra garments. In a staff room with a laundry appliance and kettle, physicians keep an eye on a display. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Medical personnel at an subterranean hospital observe a monitor showing Russian suicide and surveillance drones in the region.

This is the nation's covert underground hospital. The facility began operations in August and is the second of its kind, situated in eastern Ukraine not far from the frontline and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters under the ground. This is the safest way of providing help to our injured soldiers. And it keeps healthcare workers protected,” stated the facility's surgeon, Major the chief surgeon.

This medical station treats 30-40 casualties a day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma requiring amputations, or serious stomach wounds. Others can walk. Almost all are the victims of enemy FPV aerial devices, which release explosives with deadly precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a different kind of conflict,” the doctor said.

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

During one day recently, a group of three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had ripped a minor wound in his leg. “War is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians released a another explosive on him.” He continued: “Everything in the village is demolished. We see drones all around and bodies. Ours and the enemy's.”

Dvorskyi said his unit spent 43 days in a forest area near the city, which enemy forces has been trying to seize for many months. The only way to get to their location was by walking. All supplies came by drone: rations and water. A week after he was injured, he traveled five kilometers (roughly three miles), taking several hours, to where an military transport was able to pick him up. Upon arrival, a medic checked his physical condition. Following care, a nurse gave him fresh non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, 28, said a first-person view aerial device caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly became black. I lost sensation any feeling or any sound,” he explained. “I believe I was lucky to survive. My cousin has been lost. We face continuous detonations.” A builder employed in a neighboring country, Filipchuk said he had returned to his homeland and volunteered to fight shortly before the Russian leader's full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He groaned as medical staff laid him on a bed, took off a stained bandage and treated his recent injury from fragments. Covered in a foil blanket, he borrowed a cellphone to call his sister. “A piece of artillery struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To recover. That will take a several months. After that, to return to my military group. Someone has to protect our nation,” he said.

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, health facilities, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been fatally attacked in almost two thousand attacks. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, soil and granular material placed above reaching the surface. It can withstand direct hits from large-caliber projectiles and even three 8kg TNT charges dropped by aerial means.

A major industrial group, which funded the building, intends to build 20 facilities in all. A senior official of Ukraine’s security agency and former defence minister, the official, declared they would be “critically essential for saving the survival of our military and assisting defenders on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken since Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, explained certain injured soldiers had to endure delays hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had two severely injured casualties who arrived at the early hours. I had to carry out a double amputation on a patient. The soldier's tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in healthcare for 20 years. You have to concentrate,” he said.

Orderlies wheeled the soldier up the passage and into an ambulance. The transport was stationed under a shrub. The patient and the other military members were transferred to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The facility's ginger cat, the mascot, padded toward the doorway to await the incoming patients. “We are open 24 hours a day,” the surgeon said. “The work is continuous.”