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Scrubby foliage conceal the entrance. A sloping wooden tunnel leads down to a brightly lit reception area. There is a surgery unit, outfitted with beds, heart rate sensors and ventilators. Plus shelves stocked of medical equipment, drugs and organized stacks of extra garments. In a break area with a laundry appliance and kettle, physicians monitor a display. It shows the movements of enemy surveillance UAVs as they zigzag in the sky above.

Medical staff at an subterranean medical center observe a monitor displaying Russian kamikaze and surveillance UAVs in the area.

This is the nation's covert below-ground hospital. The facility began operations in August and is the second of its kind, situated in the eastern part of the country not far from the frontline and the urban area of a key location in the Donetsk region. “We are six meters under the ground. It’s the most secure way of providing help to our wounded soldiers. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have devastating limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian FPV aerial devices, which release explosives with deadly precision. “90% of our patients are from first-person view drones. We see few bullet injuries. This is an era of drones and a different kind of war,” the surgeon said.

Major the senior surgeon at the underground facility for caring for wounded troops in eastern Ukraine.

On one afternoon recently, three military members limped into the hospital. The least severely hurt, 28-year-old one soldier, said an first-person view drone explosion had ripped a minor wound in his limb. “Conflict is horrific. My comrade beside me, Vasyl, was fatally wounded,” he said. “He fell down. Subsequently the Russians released a another grenade on him.” He continued: “Everything in the settlement is demolished. We see drones everywhere and bodies. Ours and theirs.”

Dvorskyi explained his unit endured 43 days in a forest area near the city, which enemy forces has been attempting to capture since last year. Sole access to reach their position was by walking. Necessary provisions came by drone: rations and drinking water. A week after he was hurt, he traveled 5km (about 3 miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a medical attendant gave him new civilian clothes: a T-shirt and a pair of pale denim trousers.

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

A different casualty, thirty-eight-year-old a serviceman, recounted a UAV explosion had left him with a head injury. “I was in a trench shelter. Suddenly it became black. I lost sensation any feeling or any sound,” he explained. “I think I was lucky to remain alive. My cousin has been lost. There are continuous detonations.” A construction worker working in Lithuania, he said he had returned to his homeland and volunteered to fight shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a bed, removed a bloody dressing and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to ring his family member. “A fragment of artillery struck me. It was a ricochet. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. After that, to return to my unit. Someone has to defend our country,” he said.

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

Over the past years, Russia has repeatedly targeted hospitals, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred medical personnel have been killed in nearly 2,000 attacks. The underground facility is built from multiple reinforced shelters, with timber beams, earth and sand placed above reaching ground level. It is designed to resist direct hits from 152mm projectiles and even three 8kg TNT charges released by aerial means.

A major steel and mining company, which funded the building, plans to erect twenty facilities in all. A senior official of the nation's national security council and former defence minister, Rustem Umerov, declared they would be “vitally important for saving the survival of our military and supporting troops on the frontline.” The company referred to the initiative as the “largest-scale and demanding” it had implemented since the enemy's invasion.

An example of the facility's surgical rooms.

The surgeon, said certain wounded soldiers had to wait many hours or even multiple days before they could be transported due to the danger of air assaults. “We had a pair of critically ill casualties who arrived at 3am. 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 other option.” What is his method with severe operations? “My career in healthcare for two decades. One must concentrate,” he remarked.

Medical assistants transported Mykolaichuk through the tunnel and into an emergency vehicle. The transport was parked under a shrub. The patient and the two other soldiers were taken to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded up to the doorway to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon stated. “The work is continuous.”