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Scrubby foliage conceal the entryway. A sloping wooden passageway descends to a brightly lit reception area. Inside lies a operating ward, equipped with beds, heart rate sensors and ventilators. Plus shelves stocked of healthcare supplies, medications and organized stacks of extra garments. In a break area with a washing machine and hot water heater, doctors keep an eye on a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the sky above.

Hospital personnel at an subterranean hospital look at a screen displaying enemy kamikaze and surveillance drones in the area.

Welcome to the nation's secret underground hospital. This center began operations in August and is the second such installation, located in the eastern part of the country not far from the frontline and the city of a key location in the Donetsk region. “We are 6 metres below the ground. It’s the safest method of providing help to our injured military personnel. It also ensures medical personnel protected,” stated the facility's lead doctor, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or severe abdominal injuries. Some patients can move on their own. Almost all are the casualties of Russian first-person view (FPV) drones, which release explosives with deadly precision. “90% of our patients are from first-person view drones. We see minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of conflict,” the doctor said.

Major the senior surgeon at the underground facility for caring for wounded soldiers in eastern Ukraine.

On one afternoon last week, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, reported an FPV explosion had ripped a minor wound in his leg. “Conflict is horrific. The guy beside me, Vasyl, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a second grenade on him.” He continued: “All structures in the village is destroyed. There are drones all around and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad endured 43 days in a forest area near the city, which Russia has been attempting to capture for many months. The only way to get to their location was on foot. All supplies arrived by quadcopter: food and drinking water. Seven days following he was injured, he traveled 5km (about 3 miles), requiring three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a set of light-colored jeans.

The soldier, twenty-eight, said a FPV drone caused a minor injury in his leg.

Another patient, 38-year-old a serviceman, recounted a UAV explosion had resulted in a head injury. “I was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. A relative has been lost. We face ongoing explosions.” A construction worker working in Lithuania, Filipchuk said he had come back to Ukraine and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been hit in the back. He groaned as medical staff placed him on a bed, removed a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a mobile phone to ring his family member. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. That will take a several months. After that, to return to my military group. Our forces must protect our nation,” he said.

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

Since 2022, enemy forces has repeatedly targeted medical centers, health facilities, obstetric units and ambulances. Per human rights groups, 261 medical personnel have been killed in almost 2,000 attacks. The underground facility is built from multiple steel bunkers, with timber beams, soil and granular material laid on top up to ground level. It can withstand direct hits from large-caliber artillery shells and even three 8kg explosive devices dropped by aerial means.

The Ukrainian industrial group, which financed the construction, intends to build 20 facilities in all. A senior official of the nation's national security council and ex- defence minister, the official, declared they would be “critically important for saving the survival of our armed forces and supporting defenders on the frontline.” The company referred to the initiative as the “most ambitious and challenging” it had implemented after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, said some wounded soldiers had to wait hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “Our facility received a pair of critically ill patients who came at 3am. I had 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 traumatic surgeries? “I’ve been medicine for 20 years. One must focus,” he remarked.

Medical assistants wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The transport was stationed under a bush. The patient and the other soldiers were taken to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, Vasilevs, padded toward the entrance to greet the incoming patients. “We are active around the clock,” Holovashchenko said. “The work is continuous.”