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Sparse trees conceal the entrance. A descending timber passageway descends to a well-illuminated reception area. Inside lies a operating ward, outfitted with beds, heart rate sensors and breathing machines. And shelves full of healthcare supplies, drugs and organized stacks of spare clothes. In a break area with a washing machine and hot water heater, physicians keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they weave in the sky above.

Hospital staff at an subterranean hospital look at a monitor showing enemy kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s secret underground hospital. The facility began operations in August and is the second of its kind, located in eastern Ukraine not far from the frontline and the city of a key location in the Donetsk region. “Our facility sits six meters below the earth. It’s the safest way of delivering care to our injured military personnel. And it keeps medical personnel safe,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 casualties a each day. Their conditions vary. Some have devastating limb trauma necessitating amputations, or severe abdominal injuries. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “90% of our patients are from first-person view drones. We encounter few bullet injuries. This is an age of unmanned aircraft and a different kind of war,” the doctor explained.

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

During one day last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces dropped a another grenade on him.” He added: “Everything in the village is demolished. We see UAVs all around and bodies. Ours and the enemy's.”

Dvorskyi explained his unit endured over a month in a wooded zone close to the city, which enemy forces has been trying to seize since last year. Sole access to reach their position was on foot. Necessary provisions arrived by quadcopter: food and drinking water. A week following he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his physical condition. Following care, a nurse gave him fresh non-military attire: a shirt and a pair of pale jeans.

Artem Dvorskiy, twenty-eight, said a FPV aerial device caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a drone blast had resulted in a head injury. “I was in a dugout. It suddenly went dark. I lost sensation anything or any sound,” he said. “I believe I was lucky to remain alive. A relative has been lost. We face ongoing explosions.” A construction worker working in a neighboring country, he noted he had come back to his homeland and enlisted to fight days before the Russian leader'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 bandage and treated his two-day-old shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to ring his sister. “A fragment of artillery hit me. The cause was a ricochet. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. After that, to return to my military group. Our forces must defend our nation,” he affirmed.

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

Since 2022, enemy forces has consistently attacked hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 medical personnel have been fatally attacked in almost two thousand attacks. This subterranean hospital is constructed from four steel bunkers, with wooden supports, soil and granular material laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even three 8kg TNT charges released by drone.

A major industrial group, which financed the construction, intends to erect twenty units in all. The head of the nation's security agency and ex- military leader, Rustem Umerov, declared they would be “vitally 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 demanding” it had implemented since Russia’s invasion.

One of the centre’s surgical rooms.

The surgeon, said some injured soldiers had to wait hours or even multiple days before they could be evacuated due to the danger of aerial attacks. “Our facility received two critically ill patients who came at 3am. It was necessary to carry out a double amputation on one of them. The soldier's bleeding control device had been on for so long there was no other option.” How did he cope with severe surgeries? “I’ve been healthcare for two decades. You have to focus,” he said.

Medical assistants wheeled the soldier up the tunnel and into an emergency vehicle. The transport was parked under a shrub. He and the other soldiers were taken to the urban center of Dnipro for further treatment. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates active 24 hours a day,” Holovashchenko said. “The work is continuous.”