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Scrubby foliage conceal the entryway. A descending wooden passageway leads down to a brightly lit welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and breathing machines. Plus shelves stocked of medical equipment, medications and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, doctors monitor a screen. It shows the flight patterns of Russian spy drones as they weave in the sky above.

Medical staff at an underground medical center look at a screen showing Russian suicide and surveillance UAVs in the region.

Welcome to Ukraine’s covert underground hospital. This center opened in August and is the second such installation, situated in the eastern part of the country close to the frontline and the urban area of a key location in the Donetsk region. “We are 6 metres under the earth. This is the most secure method of providing help to our wounded military personnel. And it keeps medical personnel safe,” said the clinic’s surgeon, Maj the chief surgeon.

The stabilisation point treats 30-40 patients a day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) drones, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. It’s an era of unmanned aircraft and a different kind of war,” the doctor explained.

Major Oleksandr Holovashchenko at the underground facility for treating injured soldiers in the eastern region.

On one day recently, three soldiers walked with difficulty into the facility. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone blast had torn a small hole in his leg. “War is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He collapsed. Then the enemy forces released a second explosive on him.” He continued: “Everything in the village is destroyed. We see drones all around and bodies. Ours and the enemy's.”

The soldier said his squad spent 43 days in a forest area near Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to get to their position was by walking. All supplies came by quadcopter: food and drinking water. Seven days following 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. Upon arrival, a medic assessed his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, said a first-person view aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old a serviceman, said a drone blast had resulted in a head injury. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or any sound,” he explained. “I think I was lucky to remain alive. My cousin has been lost. There are ongoing detonations.” A builder employed in a neighboring country, he noted he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He expressed pain as doctors placed him on a medical cot, removed a stained dressing and treated his two-day-old injury from fragments. Covered in a foil blanket, he borrowed a cellphone to ring his sister. “A piece of mortar hit me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To recover. That will take a several months. After that, to return to my unit. Our forces has to defend our country,” he said.

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

Over the past years, enemy forces has repeatedly targeted hospitals, clinics, maternity wards and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, soil and granular material laid on top up to the surface. It is designed to resist impacts from large-caliber artillery shells and even three eight-kilogram explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which financed the construction, intends to erect 20 facilities in all. The head of the nation's national security council and former military leader, Rustem Umerov, declared they would be “critically essential for preserving the survival of our armed forces and assisting defenders on the frontline.” The company referred to the project as the “most ambitious and demanding” it had implemented since the enemy's invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained some wounded soldiers had to wait hours or even multiple days before they could be evacuated because of the danger of air assaults. “We had two severely injured casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been applied for so long there was no other option.” What is his method with severe operations? “My career in healthcare for two decades. One must concentrate,” he said.

Orderlies wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was parked under a shrub. The patient and the two other soldiers were taken to the city of a major city for further treatment. The subterranean medical team took a break. The facility's ginger cat, Vasilevs, padded up to the doorway to greet the next arrivals. “Our facility operates open 24 hours a day,” the surgeon said. “The work is continuous.”