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Sparse foliage conceal the entrance. One sloping timber passageway descends to a well-illuminated welcome zone. There is a surgery unit, equipped with gurneys, cardiac monitors and ventilators. Plus cabinets full of healthcare supplies, medications and neat piles of extra garments. Within a staff room with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Medical staff at an underground hospital look at a monitor showing enemy kamikaze and surveillance drones in the area.

This is the nation's covert underground medical facility. The facility opened in August and is the second of its kind, situated in the eastern part of the country not far from the frontline and the city of a key location in Donetsk oblast. “Our facility sits six meters below the ground. This is the most secure method of providing help to our injured military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Major Oleksandr Holovashchenko.

This medical station treats 30-40 patients a day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring amputations, or severe stomach wounds. Some patients can walk. Almost all are the victims of enemy first-person view (FPV) aerial devices, which drop explosives with deadly accuracy. “Ninety per cent of our patients are from FPVs. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj Oleksandr Holovashchenko at the underground installation for treating injured soldiers in the eastern region.

On one day recently, a group of three military members walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an first-person view drone explosion had torn a minor wound in his limb. “Conflict is terrible. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces dropped a another explosive on him.” He added: “Everything in the settlement is demolished. There are drones everywhere and bodies. Our side's and theirs.”

The soldier explained his unit spent over a month in a wooded zone near the city, which enemy forces has been trying to seize since last year. The only way to reach their position was by walking. Necessary provisions came by quadcopter: food and water. Seven days following he was hurt, he walked 5km (about 3 miles), requiring several hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff checked his physical condition. Following care, a medical attendant provided him with new non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, 28, stated a FPV drone ripped a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had left him with a head injury. “I was in a dugout. Suddenly it became black. I couldn’t feel anything or hear anything,” he said. “I think I was lucky to survive. A relative has been killed. There are continuous detonations.” A builder employed in a neighboring country, he noted he had returned to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as medical staff laid him on a bed, took off a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a mobile phone to ring his family member. “A piece of artillery hit me. It was a ricochet. My condition is stable,” he informed her. What comes next for him? “To recover. This may require a few months. After that, to go back to my military group. Our forces has to protect our nation,” he said.

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

Over the past years, Russia has consistently attacked medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 health workers have been fatally attacked in nearly two thousand assaults. This subterranean hospital is built from four reinforced shelters, with wooden supports, soil and granular material laid on top up to the surface. It can withstand direct hits from 152mm artillery shells and even multiple 8kg TNT charges dropped by aerial means.

A major industrial group, which funded the construction, intends to erect twenty facilities in all. The head of the nation's national security council and ex- defence minister, the official, said they would be “critically important for saving the lives of our armed forces and supporting defenders on the frontline.” The company described the project as the “most ambitious and challenging” it had implemented after Russia’s invasion.

One of the centre’s surgical rooms.

The surgeon, explained certain wounded personnel had to endure delays hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received two severely injured casualties who arrived at the early hours. It was necessary to perform a double amputation on a patient. The soldier's tourniquet had been on for such an extended period there was no other option.” What is his method with severe surgeries? “My career in healthcare for 20 years. One must concentrate,” he said.

Medical assistants wheeled the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed beneath a bush. He and the other soldiers were transferred to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The facility's orange feline, the mascot, walked toward the entrance to greet the incoming patients. “We are active around the clock,” the surgeon said. “The work is continuous.”