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Sparse trees conceal the entrance. One sloping wooden tunnel descends to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and breathing machines. And cabinets stocked of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. The screen reveals the movements of enemy spy drones as they zigzag in the sky above.

Medical staff at an subterranean hospital look at a monitor displaying enemy suicide and reconnaissance drones in the region.

Welcome to the nation's covert underground hospital. This center opened in the eighth month and is the second of its kind, situated in the eastern part of the country not far from the combat zone and the city of a key location in the Donetsk region. “Our facility sits six meters under the earth. It’s the most secure way of delivering care to our wounded soldiers. And it keeps medical personnel safe,” stated the facility's lead doctor, Major the chief surgeon.

This medical station treats thirty to forty casualties a day. Their conditions vary. Some have catastrophic limb trauma requiring amputations, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of Russian first-person view (FPV) drones, which release explosives with deadly accuracy. “90% of our patients are from first-person view drones. We encounter minimal bullet injuries. This is an era of drones and a different kind of conflict,” the doctor said.

Maj the senior surgeon at the subterranean facility for treating wounded soldiers in eastern Ukraine.

During one afternoon last week, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, said an FPV blast had ripped a small hole in his limb. “War is terrible. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the enemy forces dropped a second grenade on him.” He added: “Everything in the village is demolished. There are drones everywhere and casualties. Our side's and theirs.”

The soldier said his unit spent 43 days in a forest area near Pokrovsk, which enemy forces has been attempting to capture for many months. The only way to get to their position was by walking. Necessary provisions came by quadcopter: rations and water. A week after he was hurt, he traveled 5km (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. At the clinic, a medic assessed his physical condition. After treatment, a medical attendant provided him with new civilian clothes: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or any sound,” he explained. “I think I was lucky to survive. A relative has been lost. We face ongoing detonations.” A builder employed in a neighboring country, he said he had come back to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He groaned as doctors placed him on a medical cot, removed a stained dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar struck me. It was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a several months. After that, to return to my military group. Our forces has to protect our nation,” he said.

Medical staff care for the wounded soldier, who was injured in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred health workers have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from multiple reinforced shelters, with wooden supports, soil and granular material laid on top reaching ground level. It is designed to resist direct hits from 152mm projectiles and even three eight-kilogram explosive devices dropped by drone.

A major industrial group, which funded the construction, intends to build 20 facilities in total. The head of Ukraine’s security agency and ex- defence minister, Rustem Umerov, said they would be “critically essential for saving the lives of our military and assisting defenders on the battlefront.” The company referred to the project as the “largest-scale and challenging” it had undertaken after Russia’s invasion.

One of the facility's operating theatres.

Holovashchenko, explained certain injured soldiers had to wait hours or even multiple days before they could be transported because of the threat of aerial attacks. “Our facility received two critically ill casualties who came at 3am. It was necessary to carry out a removal of both limbs on a patient. His bleeding control device had been applied for such an extended period there was no other option.” How did he cope with severe surgeries? “I’ve been healthcare for 20 years. One must focus,” he remarked.

Orderlies transported the soldier up the passage and into an ambulance. The vehicle was parked under a bush. The patient and the other soldiers were transferred to the urban center of a major city for additional medical care. The underground medical team took a break. The hospital’s ginger cat, Vasilevs, padded toward the entrance to await the next arrivals. “Our facility operates active around the clock,” the surgeon stated. “It doesn’t stop.”