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Sparse trees hide the entrance. One sloping timber tunnel leads down to a well-illuminated reception area. There is a operating ward, equipped with beds, cardiac monitors and breathing machines. And cabinets full of healthcare supplies, medications and neat piles of spare clothes. In a break area with a washing machine and hot water heater, physicians keep an eye on a display. It shows the flight patterns of enemy spy drones as they zigzag in the sky above.

Medical staff at an subterranean hospital look at a monitor showing Russian suicide and surveillance drones in the area.

This is Ukraine’s secret underground hospital. This center began operations in the eighth month and is the second such installation, located in eastern Ukraine close to the combat zone and the urban area of a key location in the Donetsk region. “We are 6 metres under the ground. This is the most secure way of providing help to our wounded military personnel. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj the chief surgeon.

This medical station treats thirty to forty casualties a day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or serious abdominal injuries. Some patients can move on their own. The vast majority are the victims of enemy FPV aerial devices, which release explosives with deadly precision. “Ninety per cent of our cases are from first-person view drones. We encounter minimal bullet injuries. It’s an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Maj the senior surgeon at the subterranean installation for caring for wounded troops in the eastern region.

During one afternoon recently, three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is terrible. My comrade next to me, Vasyl, was killed,” he stated. “He collapsed. Subsequently the enemy forces released a second grenade on him.” He continued: “Everything in the settlement is demolished. We see drones all around and bodies. Our side's and theirs.”

The soldier said his unit spent 43 days in a forest area near Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to reach their position was by walking. All supplies arrived by drone: food and drinking water. Seven days after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant gave him fresh non-military attire: a T-shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, said a first-person view drone caused a small hole in his lower limb.

A different casualty, 38-year-old a serviceman, said a drone blast 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 explained. “I think I was fortunate to survive. My cousin has been killed. We face ongoing detonations.” A builder employed in Lithuania, Filipchuk said he had come back to his homeland and volunteered to serve days before Vladimir Putin’s large-scale attack in early 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as doctors placed him on a bed, took off a stained bandage and treated his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to ring his sister. “A fragment of mortar struck me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To recover. That will take a few months. Subsequently, to go back to my unit. Our forces has to protect our nation,” he said.

Doctors treat Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted medical centers, health facilities, maternity wards and emergency vehicles. Per international monitors, over two hundred health workers have been killed in almost 2,000 attacks. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, earth and sand laid on top reaching the surface. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg TNT charges released by aerial means.

The Ukrainian industrial group, which financed the construction, intends to build 20 facilities in total. The head of Ukraine’s security agency and former defence minister, the official, declared they would be “critically essential for saving the survival of our military and supporting troops on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

One of the centre’s operating theatres.

The surgeon, explained certain wounded personnel had to endure delays hours or even days before they could be evacuated because of the danger of air assaults. “We had two critically ill patients who came at the early hours. I had to carry out a double amputation on a patient. His tourniquet 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 focus,” he remarked.

Medical assistants wheeled the soldier up the passage and into an emergency vehicle. The vehicle was stationed under a shrub. He and the two other military members were transferred to the urban center of Dnipro for additional medical care. The subterranean hospital staff took a break. The hospital’s orange feline, the mascot, walked toward the doorway to await the incoming patients. “We are open around the clock,” Holovashchenko said. “The work is continuous.”