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Scrubby foliage conceal the entrance. A sloping wooden passageway descends to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. And shelves full of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a washing machine and kettle, physicians keep an eye on a screen. It shows the movements of enemy surveillance UAVs as they zigzag in the sky above.

Medical personnel at an underground hospital observe a screen showing Russian kamikaze and reconnaissance drones in the area.

This is the nation's covert underground hospital. The facility began operations in August and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of a key location in Donetsk oblast. “We are 6 metres below the earth. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” stated the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring amputations, or serious stomach wounds. Others can walk. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from first-person view drones. We see few bullet injuries. It’s an age of drones and a new type of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean installation for treating injured soldiers in eastern Ukraine.

During one day recently, a group of three soldiers limped into the hospital. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his leg. “War is horrific. The guy beside me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the Russians dropped a another grenade on him.” He added: “All structures in the settlement is destroyed. There are UAVs everywhere and casualties. Our side's and theirs.”

Dvorskyi said his squad spent over a month in a wooded zone close to the city, which Russia has been trying to seize since last year. The only way to reach their position was on foot. All supplies arrived by quadcopter: food and water. A week after he was injured, he traveled 5km (about 3 miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his vital signs. After treatment, a nurse provided him with fresh non-military attire: a shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view drone ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly went dark. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to survive. A relative has been lost. We face continuous explosions.” A builder working in a neighboring country, he noted he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as doctors laid him on a bed, took off a bloody dressing and treated his two-day-old injury from fragments. Covered in a foil blanket, he used a cellphone to call his family member. “A piece of artillery hit me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. This may require a several months. After that, to return to my military group. Our forces has to defend our country,” he said.

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

Over the past years, Russia has repeatedly targeted medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in almost 2,000 attacks. The underground facility is constructed from multiple steel bunkers, with wooden supports, earth and granular material laid on top up to the surface. It can withstand impacts from large-caliber projectiles and even three 8kg TNT charges dropped by drone.

A major industrial group, which financed the construction, intends to build 20 units in total. The head of Ukraine’s national security council and former military leader, the official, declared they would be “critically important for preserving the lives of our military and supporting defenders on the battlefront.” The company described the initiative as the “most ambitious and demanding” it had implemented after the enemy's invasion.

One of the facility's surgical rooms.

The surgeon, said certain injured personnel had to wait hours or even multiple days before they could be transported because of the danger of aerial attacks. “Our facility received two critically ill casualties who came at 3am. It was necessary to carry out a double amputation on a patient. His tourniquet had been on for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been medicine for 20 years. You have to concentrate,” he said.

Medical assistants wheeled the soldier up the tunnel and into an ambulance. The vehicle was parked beneath a shrub. The patient and the other soldiers were taken to the urban center of Dnipro for additional medical care. The underground hospital staff took a break. The hospital’s orange feline, the mascot, padded toward the entrance to await the next arrivals. “Our facility operates active 24 hours a day,” the surgeon said. “It doesn’t stop.”