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Sparse foliage conceal the entryway. A descending wooden tunnel leads down to a well-illuminated reception area. There is a operating ward, equipped with beds, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, physicians monitor a screen. It shows the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital staff at an underground hospital look at a screen displaying enemy kamikaze and surveillance drones in the region.

This is Ukraine’s covert underground hospital. The facility began operations in the eighth month and is the second such installation, located in eastern Ukraine close to the frontline and the city of a key location in Donetsk oblast. “Our facility sits 6 metres under the earth. It’s the safest method of delivering care to our injured military personnel. And it keeps medical personnel protected,” said the facility's lead doctor, Maj the chief surgeon.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have catastrophic leg injuries necessitating amputations, or severe stomach wounds. Some patients can move on their own. The vast majority are the casualties of enemy FPV drones, which drop grenades with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter few bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj the senior surgeon at the subterranean facility for treating wounded soldiers in the eastern region.

On one afternoon last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old Artem Dvorskyi, reported an FPV blast had ripped a small hole in his leg. “Conflict is terrible. The guy beside me, Vasyl, was fatally wounded,” he stated. “He fell down. Then the Russians dropped a another explosive on him.” He added: “Everything in the settlement is demolished. There are drones everywhere and casualties. Ours and theirs.”

Dvorskyi explained his squad spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their position was on foot. All supplies arrived by quadcopter: rations and drinking water. Seven days after he was injured, he traveled 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 assessed his physical condition. After treatment, a nurse gave him fresh civilian clothes: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view drone ripped a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “My position was in a dugout. Suddenly it became black. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to survive. A relative has been killed. We face continuous detonations.” A construction worker employed in a neighboring country, Filipchuk noted he had returned to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff placed him on a medical cot, removed a stained bandage and cleaned his two-day-old injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his sister. “A piece of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To recover. This may require a several months. After that, to return to my military group. Our forces must defend our country,” he said.

Doctors care for the wounded soldier, who was hit in the back by a fragment of mortar.

Since 2022, enemy forces has repeatedly attacked medical centers, health facilities, obstetric units and ambulances. According to international monitors, over two hundred medical personnel have been killed in nearly two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material laid on top reaching the surface. It can withstand direct hits from 152mm projectiles and even three 8kg explosive devices released by aerial means.

A major steel and mining company, which funded the building, plans to erect 20 units in all. The head of the nation's national security council and ex- defence minister, Rustem Umerov, declared they would be “vitally important for preserving the survival of our military and supporting troops on the battlefront.” The company described the project as the “most ambitious and challenging” it had undertaken after Russia’s invasion.

An example of the centre’s surgical rooms.

The surgeon, explained certain wounded personnel had to endure delays hours or even days before they could be transported due to the danger of aerial attacks. “Our facility received two severely injured casualties who came at the early hours. I had to perform a double amputation on a patient. His tourniquet had been applied for so long there was no other option.” How did he cope with severe surgeries? “My career in healthcare for two decades. You have to concentrate,” he said.

Orderlies wheeled the soldier up the tunnel and into an ambulance. The vehicle was stationed under a bush. He and the two other military members were transferred to the urban center of Dnipro for additional medical care. The subterranean hospital staff took a break. The facility's orange feline, the mascot, walked up to the entrance to greet the next arrivals. “Our facility operates open around the clock,” the surgeon stated. “The work is continuous.”