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Sparse foliage conceal the entrance. A sloping timber tunnel leads down to a brightly lit reception area. There is a operating ward, equipped with beds, heart rate sensors and breathing machines. Plus cabinets stocked of medical equipment, drugs and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, physicians monitor a display. It shows the movements of Russian spy drones as they weave in the air above.

Hospital personnel at an subterranean medical center observe a screen showing Russian suicide and surveillance UAVs in the area.

Welcome to Ukraine’s secret below-ground hospital. This center began operations in August and is the second such installation, situated in the eastern part of the country close to the combat zone and the urban area of a key location in Donetsk oblast. “We are 6 metres under the ground. It’s the safest way of providing help to our wounded military personnel. And it keeps healthcare workers safe,” stated the facility's lead doctor, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or serious stomach wounds. Others can walk. Almost all are the victims of enemy FPV aerial devices, which release explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean installation for caring for wounded troops in eastern Ukraine.

On one afternoon last week, a group of three military members limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his limb. “Conflict is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the enemy forces dropped a another explosive on him.” He continued: “All structures in the village is destroyed. There are UAVs all around and bodies. Our side's and the enemy's.”

Dvorskyi explained his unit spent over a month in a forest area near Pokrovsk, which Russia has been attempting to capture since last year. The only way to get to their location was on foot. Necessary provisions arrived by quadcopter: rations and water. A week after he was injured, he traveled 5km (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a T-shirt and a pair of pale denim trousers.

Artem Dvorskiy, 28, said a FPV aerial device caused a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “My position was in a dugout. It suddenly became black. I couldn’t feel any feeling or hear anything,” he said. “I think I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A construction worker employed in Lithuania, Filipchuk noted he had come back to his homeland and enlisted to serve days before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as medical staff placed him on a medical cot, took off a stained dressing and treated his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A fragment of mortar struck me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. This may require a few months. After that, to return to my unit. Our forces has to defend our country,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of artillery shell.

Over the past years, enemy forces has consistently targeted medical centers, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred medical personnel have been fatally attacked in almost two thousand attacks. The underground facility is constructed from multiple steel bunkers, with timber beams, soil and granular material placed above up to the surface. It is designed to resist direct hits from large-caliber artillery shells and even multiple eight-kilogram explosive devices released by drone.

The Ukrainian industrial group, which funded the construction, intends to erect twenty facilities in total. The head of Ukraine’s security agency and former military leader, the official, said they would be “vitally important for saving the survival of our military and supporting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had implemented after the enemy's military offensive.

One of the centre’s surgical rooms.

The surgeon, explained certain wounded personnel had to wait many hours or even multiple days before they could be transported due to the threat of aerial attacks. “We had a pair of critically ill patients who came at 3am. I had to carry out a removal of both limbs on a patient. His bleeding control device had been applied for so long there was no other option.” What is his method with traumatic surgeries? “My career in healthcare for 20 years. One must focus,” he remarked.

Orderlies wheeled Mykolaichuk up the tunnel and into an ambulance. The vehicle was parked beneath a bush. He and the two other soldiers were transferred to the city of Dnipro for additional medical care. The underground medical team paused for rest. The hospital’s ginger cat, Vasilevs, walked up to the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko stated. “The work is continuous.”