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Sparse trees conceal the entrance. One descending wooden passageway leads down to a brightly lit welcome zone. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, drugs and neat piles of spare clothes. Within a break area with a laundry appliance and kettle, doctors monitor a screen. The screen reveals the movements of Russian spy drones as they weave in the air above.

Medical staff at an subterranean hospital observe a monitor showing Russian kamikaze and reconnaissance drones in the area.

This is the nation's covert underground hospital. The facility began operations in the eighth month and is the second of its kind, located in eastern Ukraine not far from the combat zone and the urban area of a key location in Donetsk oblast. “We are 6 metres below the earth. It’s the safest method of providing help to our wounded military personnel. It also ensures medical personnel protected,” said the facility's surgeon, Maj the chief surgeon.

This medical station handles 30-40 casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or severe stomach wounds. Others can walk. Almost all are the victims of Russian FPV aerial devices, which release grenades with lethal precision. “90% of our cases are from FPVs. We see minimal gunshot wounds. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for caring for wounded soldiers in the eastern region.

On one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an FPV blast had torn a small hole in his leg. “Conflict is horrific. The guy next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians dropped a second explosive on him.” He added: “Everything in the settlement is demolished. We see drones everywhere and casualties. Ours and the enemy's.”

Dvorskyi explained his squad spent over a month in a forest area close to the city, which enemy forces has been trying to seize since last year. Sole access to get to their location was by walking. All supplies arrived by quadcopter: rations and drinking water. A week after he was injured, he walked 5km (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his physical condition. Following care, a nurse gave him fresh civilian clothes: a T-shirt and a set of pale jeans.

Artem Dvorskiy, 28, stated a first-person view drone ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, said a UAV explosion had resulted in a head injury. “I was in a trench shelter. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he said. “I think I was fortunate to survive. A relative has been killed. There are continuous explosions.” A construction worker working in a neighboring country, Filipchuk said he had come back to Ukraine and enlisted to serve days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as doctors placed him on a medical cot, removed a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To get better. That will take a few months. Subsequently, to go back to my military group. Our forces must defend our nation,” he said.

Doctors treat Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, obstetric units and ambulances. Per international monitors, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is built from four steel bunkers, with wooden supports, soil and granular material placed above up to ground level. It is designed to resist impacts from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by drone.

The Ukrainian steel and mining company, which financed the construction, plans to build 20 facilities in all. A senior official of the nation's security agency and ex- defence minister, the official, said they would be “vitally essential for saving the survival of our armed forces and supporting troops on the battlefront.” The organization described the initiative as the “largest-scale and demanding” it had implemented since the enemy's military offensive.

One of the facility's operating theatres.

The surgeon, explained certain wounded soldiers had to wait hours or even days before they could be evacuated because of the danger of air assaults. “We had a pair of severely injured patients who came at the early hours. It was necessary to perform a removal of both limbs on one of them. His bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for 20 years. You have to concentrate,” he remarked.

Medical assistants transported the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. The patient and the two other soldiers were taken to the urban center of a major city for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, the mascot, walked toward the entrance to greet the next arrivals. “We are active around the clock,” the surgeon said. “The work is continuous.”