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Sparse foliage hide the entrance. A sloping wooden passageway leads down to a brightly lit reception area. There is a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus shelves full of healthcare supplies, drugs and organized stacks of spare clothes. Within a break area with a washing machine and kettle, doctors monitor a display. The screen reveals the flight patterns of Russian spy drones as they zigzag in the air above.

Medical staff at an underground medical center observe a monitor displaying Russian kamikaze and reconnaissance drones in the region.

Welcome to Ukraine’s covert underground hospital. The facility began operations in August and is the second such installation, located in eastern Ukraine close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres under the earth. This is the most secure way of providing help to our injured soldiers. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 patients a day. Cases differ widely. Some have devastating leg injuries necessitating amputations, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of enemy FPV aerial devices, which drop grenades with lethal accuracy. “90% of our patients are from FPVs. We encounter minimal bullet injuries. This is an era of unmanned aircraft and a new type of conflict,” the doctor said.

Maj the senior surgeon at the underground installation for treating wounded troops in the eastern region.

On one day last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone blast had ripped a minor wound in his leg. “War is terrible. The guy beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Subsequently the enemy forces released a second explosive on him.” He continued: “All structures in the village is destroyed. We see drones everywhere and casualties. Our side's and theirs.”

Dvorskyi said his unit endured over a month in a forest area close to Pokrovsk, which enemy forces has been trying to seize since last year. The only way to reach their location was by walking. All supplies came by drone: rations and drinking water. A week after he was hurt, he traveled five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff checked his vital signs. Following care, a medical attendant gave him fresh non-military attire: a shirt and a set of light-colored jeans.

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

A different casualty, 38-year-old a serviceman, said a drone blast had left him with a head injury. “My position was in a trench shelter. Suddenly it became black. I lost sensation any feeling or any sound,” he explained. “I think I was fortunate to survive. A relative has been lost. We face ongoing explosions.” A construction worker employed in Lithuania, Filipchuk said he had come back to his homeland and enlisted to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff laid him on a medical cot, took off a stained dressing and treated his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to call his family member. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a few months. Subsequently, to go back to my unit. Someone has to defend our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, Russia has repeatedly targeted hospitals, health facilities, maternity wards and ambulances. According to international monitors, over two hundred medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, earth and granular material placed above reaching ground level. It is designed to resist impacts from large-caliber artillery shells and even three 8kg explosive devices dropped by aerial means.

A major industrial group, which financed the construction, plans to build twenty facilities in total. A senior official of the nation's security agency and former military leader, the official, said they would be “vitally important for saving the survival of our military and supporting troops on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained certain wounded personnel had to wait many hours or even days before they could be transported because of the threat of air assaults. “We had two critically ill patients who came at the early hours. It was necessary to perform a double amputation on one of them. The soldier's tourniquet had been applied for such an extended period there was no other option.” How did he cope with traumatic operations? “I’ve been medicine for two decades. You have to concentrate,” he remarked.

Orderlies wheeled the soldier up the passage and into an emergency vehicle. The transport was parked under a bush. He and the two other military members were taken to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko said. “It doesn’t stop.”