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Sparse foliage hide the entrance. A descending wooden passageway leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with beds, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, drugs and organized stacks of spare clothes. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. It shows the movements of Russian spy drones as they weave in the sky above.

Medical staff at an subterranean hospital observe a screen showing Russian suicide and reconnaissance UAVs in the region.

Welcome to the nation's covert below-ground hospital. The facility began operations in August and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of Pokrovsk in Donetsk oblast. “We are six meters below the ground. This is the safest method of delivering care to our injured soldiers. And it keeps medical personnel protected,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring amputations, or serious stomach wounds. Others can move on their own. The vast majority are the victims of Russian first-person view (FPV) drones, which release grenades with lethal accuracy. “90% of our patients are from first-person view drones. We see minimal bullet injuries. It’s an age of drones and a different kind of war,” the doctor said.

Major the senior surgeon at the subterranean installation for treating injured soldiers in eastern Ukraine.

During one afternoon last week, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his leg. “Conflict is terrible. The guy next to me, Vasyl, was killed,” he said. “He fell down. Then the Russians released a another grenade on him.” He continued: “All structures in the village is demolished. We see UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his squad spent over a month in a forest area close to the city, which enemy forces has been trying to seize for many months. Sole access to get to their position was by walking. Necessary provisions arrived by quadcopter: rations and water. A week following he was hurt, he traveled five kilometers (roughly three miles), taking three hours, to where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his physical condition. After treatment, a nurse provided him with new civilian clothes: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, 28, stated a FPV aerial device ripped a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he explained. “I think I was lucky to remain alive. My cousin has been lost. We face ongoing explosions.” A builder employed in a neighboring country, he noted he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as medical staff laid him on a bed, removed a stained dressing and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to call his family member. “A piece of mortar hit me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To recover. This may require a several months. Subsequently, to return to my unit. Our forces must defend our nation,” he affirmed.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently attacked medical centers, clinics, maternity wards and ambulances. Per human rights groups, 261 medical personnel have been killed in almost two thousand assaults. This subterranean hospital is built from multiple reinforced shelters, with wooden supports, soil and granular material placed above up to the surface. It is designed to resist impacts from large-caliber artillery shells and even three eight-kilogram TNT charges dropped by aerial means.

A major steel and mining company, which funded the building, plans to erect 20 units in all. The head of the nation's national security council and ex- defence minister, the official, declared they would be “critically essential for preserving the lives of our military and supporting troops on the battlefront.” The company described the project as the “largest-scale and demanding” it had undertaken after Russia’s military offensive.

An example of the centre’s operating theatres.

Holovashchenko, said some injured soldiers had to endure delays many hours or even multiple days before they could be evacuated because of the threat of aerial attacks. “We had two severely injured patients who arrived at 3am. It was necessary to carry out a double amputation on one of them. His tourniquet had been applied for such an extended period there was no alternative.” How did he cope with severe operations? “My career in medicine for 20 years. One must concentrate,” he said.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The vehicle was parked beneath a bush. The patient and the two other soldiers were transferred to the urban center of Dnipro for additional medical care. The underground medical team took a break. The facility's ginger cat, the mascot, walked toward the doorway to greet the incoming patients. “We are open around the clock,” Holovashchenko stated. “The work is continuous.”