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Sparse foliage hide the entrance. A descending timber passageway descends to a brightly lit welcome zone. Inside lies a operating ward, equipped with beds, cardiac monitors and ventilators. And cabinets full of healthcare supplies, medications and neat piles of spare clothes. In a staff room with a laundry appliance and kettle, doctors keep an eye on a screen. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Medical staff at an subterranean medical center look at a monitor displaying Russian suicide and surveillance drones in the area.

Welcome to the nation's secret below-ground hospital. This center opened in August and is the second such installation, situated in the eastern part of the country not far from the frontline and the urban area of a key location in Donetsk oblast. “We are six meters under the ground. This is the most secure method of providing help to our wounded military personnel. It also ensures healthcare workers safe,” stated the clinic’s surgeon, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating surgical removal, or serious stomach wounds. Others can walk. The vast majority are the casualties of Russian first-person view (FPV) aerial devices, which drop grenades with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter minimal bullet injuries. This is an age of unmanned aircraft and a different kind of conflict,” the doctor said.

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

On one afternoon last week, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV blast had ripped a small hole in his limb. “Conflict is terrible. My comrade beside me, Vasyl, was killed,” he stated. “He collapsed. Then the Russians released a another explosive on him.” He continued: “All structures in the settlement is destroyed. There are drones all around and bodies. Our side's and the enemy's.”

The soldier said his unit spent 43 days in a forest area close to the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was on foot. Necessary provisions came by quadcopter: food and drinking water. A week after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to a point where an military transport was able to pick him up. Upon arrival, a medic checked his vital signs. Following care, a nurse provided him with fresh non-military attire: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, said a FPV aerial device caused a small hole in his lower limb.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in concussion. “I was in a trench shelter. It suddenly became black. I couldn’t feel any feeling or hear anything,” he explained. “I believe I was lucky to survive. My cousin has been killed. We face continuous explosions.” A construction worker employed in Lithuania, he said he had returned to Ukraine and enlisted to fight shortly before Vladimir Putin’s large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a stained dressing and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a cellphone to call his family member. “A piece of mortar struck me. It was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. This may require a few months. After that, to go back to my unit. Our forces has to defend our country,” he affirmed.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has repeatedly attacked medical centers, clinics, maternity wards and ambulances. According to human rights groups, 261 medical personnel have been killed in almost two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with wooden supports, earth and granular material placed above reaching ground level. It can withstand impacts from large-caliber projectiles and even multiple eight-kilogram explosive devices dropped by aerial means.

The Ukrainian industrial group, which funded the construction, plans to erect twenty facilities in all. A senior official of the nation's security agency and former defence minister, the official, said they would be “critically important for saving the survival of our armed forces and assisting defenders on the frontline.” The company described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, explained some injured soldiers had to wait hours or even multiple days before they could be evacuated because of the danger of aerial attacks. “We had two critically ill casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with severe operations? “I’ve been medicine for 20 years. One must focus,” he said.

Medical assistants wheeled Mykolaichuk up the tunnel and into an ambulance. The transport was stationed beneath a bush. He and the two other military members were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, padded toward the doorway to greet the incoming patients. “We are open around the clock,” the surgeon said. “The work is continuous.”