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Scrubby trees hide the entrance. A sloping wooden tunnel leads down to a well-illuminated welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets full of medical equipment, drugs and neat piles of spare clothes. In a staff room with a laundry appliance and hot water heater, doctors monitor a screen. It shows the movements of Russian spy drones as they zigzag in the air above.

Hospital personnel at an subterranean medical center look at a screen showing enemy kamikaze and reconnaissance UAVs in the area.

Welcome to the nation's secret underground hospital. This center opened in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres below the ground. It’s the most secure way of delivering care to our wounded soldiers. It also ensures healthcare workers safe,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or serious abdominal injuries. Others can move on their own. Almost all are the casualties of Russian FPV aerial devices, which release explosives with lethal precision. “Ninety per cent of our cases are from FPVs. We see minimal bullet injuries. This is an age of unmanned aircraft and a different kind of conflict,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean installation for treating injured troops in the eastern region.

During one afternoon recently, three soldiers walked with difficulty into the facility. The least severely hurt, 28-year-old one soldier, said an FPV explosion had ripped a minor wound in his leg. “War is horrific. My comrade beside me, a fellow soldier, was killed,” he said. “He collapsed. Then the enemy forces dropped a second grenade on him.” He continued: “Everything in the settlement is destroyed. There are drones everywhere and casualties. Ours and the enemy's.”

The soldier said his unit spent 43 days in a forest area close to Pokrovsk, which enemy forces has been trying to seize for many months. Sole access to get to their position was by walking. All supplies came by drone: rations and drinking water. Seven days following he was injured, he walked 5km (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his physical condition. Following care, a nurse gave him fresh civilian clothes: a T-shirt and a pair of pale denim trousers.

The soldier, 28, stated a first-person view drone caused a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a trench shelter. It suddenly went dark. I couldn’t feel anything or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. There are ongoing explosions.” A builder employed in a neighboring country, he said he had returned to his homeland and enlisted to serve shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, took off a stained dressing and treated his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to call his sister. “A fragment of artillery struck me. It was a ricochet. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a few months. After that, to go back to my unit. Our forces must defend our country,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Since 2022, Russia has repeatedly attacked hospitals, clinics, maternity wards and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, earth and sand placed above reaching ground level. It is designed to resist direct hits from large-caliber artillery shells and even multiple 8kg explosive devices released by drone.

A major steel and mining company, which financed the building, plans to erect 20 facilities in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally essential for saving the survival of our armed forces and assisting defenders on the battlefront.” The organization referred to the initiative as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

One of the centre’s surgical rooms.

The surgeon, said certain injured soldiers had to endure delays hours or even multiple days before they could be evacuated because of the threat of air assaults. “Our facility received two critically ill patients who came at the early hours. I had to perform a removal of both limbs on a patient. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in healthcare for two decades. One must concentrate,” he said.

Orderlies transported the soldier up the passage and into an emergency vehicle. The vehicle was stationed under a shrub. He and the other military members were taken to the city of Dnipro for further treatment. The underground hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to await the next arrivals. “Our facility operates active 24 hours a day,” the surgeon said. “The work is continuous.”