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Sparse foliage hide the entrance. A descending timber passageway descends to a well-illuminated reception area. There is a surgery unit, equipped with beds, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, drugs and neat piles of extra garments. In a staff room with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the flight patterns of Russian spy drones as they weave in the sky above.

Hospital staff at an underground hospital observe a monitor showing enemy kamikaze and reconnaissance UAVs in the region.

Welcome to Ukraine’s secret below-ground medical facility. This center opened in August and is the second of its kind, located in the eastern part of the country not far from the combat zone and the urban area of a key location in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the most secure way of providing help to our wounded soldiers. It also ensures healthcare workers safe,” stated the clinic’s lead doctor, Major the chief surgeon.

The stabilisation point treats 30-40 casualties a each day. Their conditions vary. Some have catastrophic limb trauma requiring amputations, or severe abdominal injuries. Others can move on their own. Almost all are the casualties of enemy FPV aerial devices, which release grenades with deadly accuracy. “Ninety per cent of our cases are from FPVs. We see minimal gunshot wounds. This is an era of drones and a different kind of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating injured soldiers in the eastern region.

On one afternoon recently, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an FPV explosion had ripped a minor wound in his limb. “War is horrific. The guy next to me, Vasyl, was killed,” he said. “He collapsed. Then the Russians released a second grenade on him.” He continued: “Everything in the settlement is destroyed. We see UAVs all around and casualties. Our side's and theirs.”

The soldier said his unit spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize since last year. Sole access to get to their position was by walking. All supplies came by quadcopter: food and water. A week after he was injured, he traveled 5km (about 3 miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medic assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale jeans.

Artem Dvorskiy, 28, stated a FPV drone ripped a minor injury in his leg.

Another patient, thirty-eight-year-old Pavlo Filipchuk, said a drone blast had left him with concussion. “I was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face continuous detonations.” A construction worker working in a neighboring country, he said he had returned to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a medical cot, removed a bloody dressing and cleaned his recent injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to ring his sister. “A fragment of artillery struck me. The cause was a ricochet. I’m OK,” he informed her. What were his plans now? “To get better. That will take a several months. Subsequently, to go back to my unit. Someone has to defend our nation,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the back by a piece of artillery shell.

Over the past years, Russia has repeatedly attacked hospitals, health facilities, obstetric units and ambulances. According to international monitors, 261 medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is built from four steel bunkers, with timber beams, soil and sand placed above reaching ground level. It can withstand impacts from 152mm artillery shells and even three 8kg explosive devices dropped by aerial means.

A major industrial group, which funded the construction, intends to build twenty facilities in total. A senior official of Ukraine’s national security council and ex- military leader, Rustem Umerov, declared they would be “vitally important for saving the lives of our military and assisting troops on the battlefront.” The company described the project as the “most ambitious and challenging” it had implemented after the enemy's invasion.

An example of the centre’s operating theatres.

The surgeon, said certain wounded personnel had to wait hours or even days before they could be transported due to the threat of air assaults. “We had two critically ill casualties who arrived at 3am. It was necessary to carry out a double amputation on one of them. His tourniquet had been on for so long there was no alternative.” What is his method with severe operations? “I’ve been healthcare for 20 years. You have to focus,” he said.

Orderlies wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was parked under a bush. The patient and the two other soldiers were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff paused for rest. The hospital’s orange feline, Vasilevs, walked toward the doorway to await the next arrivals. “We are active around the clock,” the surgeon stated. “The work is continuous.”