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Scrubby foliage conceal the entryway. A descending wooden tunnel descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with beds, heart rate sensors and ventilators. And cabinets full of healthcare supplies, drugs and organized stacks of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of enemy spy drones as they zigzag in the air above.

Medical staff at an subterranean medical center look at a screen displaying enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s covert underground hospital. The facility began operations in August and is the second of its kind, located in eastern Ukraine close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits six meters below the earth. This is the most secure method of delivering care to our injured soldiers. And it keeps healthcare workers safe,” said the clinic’s surgeon, Major the chief surgeon.

This medical station treats 30-40 patients a each day. Cases differ widely. Some have devastating leg injuries requiring surgical removal, or serious stomach wounds. Some patients can move on their own. The vast majority are the victims of enemy first-person view (FPV) drones, which release explosives with deadly precision. “90% of our patients are from first-person view drones. We encounter few bullet injuries. This is an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for treating injured troops in the eastern region.

During one afternoon last week, three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “War is horrific. The guy beside me, a fellow soldier, was killed,” he said. “He fell down. Then the Russians dropped a second explosive on him.” He continued: “Everything in the village is destroyed. We see drones all around and casualties. Our side's and theirs.”

Dvorskyi explained his unit endured 43 days in a forest area near Pokrovsk, which enemy forces has been trying to seize for many months. The only way to reach their position was on foot. All supplies arrived by drone: rations and drinking water. Seven days after he was hurt, he traveled 5km (roughly three miles), taking several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his vital signs. After treatment, a nurse provided him with fresh civilian clothes: a shirt and a pair of light-colored denim trousers.

The soldier, twenty-eight, stated a FPV drone ripped a minor injury in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in concussion. “My position was in a dugout. It suddenly became black. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been lost. We face ongoing explosions.” A builder employed in Lithuania, Filipchuk said he had come back to his homeland and volunteered to fight shortly before the Russian leader's large-scale attack in early 2022.

Another military member, a serviceman, had been struck in the upper body. He groaned as medical staff placed him on a bed, removed a stained dressing and treated his recent shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. This may require a several months. After that, to go back to my military group. Someone must defend our country,” he said.

Medical staff care for the wounded soldier, who was hit in the dorsal area by a fragment of mortar.

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 nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and granular material placed above up to the surface. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg TNT charges released by aerial means.

A major steel and mining company, which financed the building, intends to build twenty units in all. The head of Ukraine’s security agency and ex- military leader, Rustem Umerov, said they would be “vitally important for saving the lives of our military and assisting troops on the battlefront.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken after the enemy's military offensive.

One of the centre’s operating theatres.

Holovashchenko, explained certain injured soldiers had to endure delays hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received a pair of critically ill casualties who came at the early hours. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been applied for such an extended period there was no other option.” How did he cope with severe operations? “I’ve been healthcare for 20 years. You have to concentrate,” he said.

Orderlies transported the soldier through the tunnel and into an ambulance. The transport was stationed under a bush. He and the other soldiers were transferred to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The hospital’s ginger cat, Vasilevs, padded up to the doorway to await the incoming patients. “We are open around the clock,” the surgeon stated. “It doesn’t stop.”