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Scrubby trees conceal the entryway. One descending timber passageway leads down to a brightly lit reception area. Inside lies a surgery unit, equipped with beds, cardiac monitors and breathing machines. Plus cabinets full of medical equipment, drugs and organized stacks of extra garments. In a staff room with a washing machine and hot water heater, physicians keep an eye on a display. It shows the flight patterns of enemy surveillance UAVs as they weave in the sky above.

Medical staff at an underground medical center look at a screen showing enemy kamikaze and surveillance drones in the region.

This is Ukraine’s covert below-ground hospital. This center began operations in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres under the earth. It’s the most secure way of delivering care to our injured soldiers. It also ensures medical personnel safe,” said the facility's surgeon, Maj the chief surgeon.

This medical station treats 30-40 casualties a each day. Their conditions vary. Certain individuals suffer from devastating leg injuries requiring surgical removal, or severe stomach wounds. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which drop grenades with deadly precision. “90% of our cases are from first-person view drones. We see minimal gunshot wounds. This is an era of drones and a different kind of conflict,” the surgeon said.

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

During one afternoon last week, three military members limped into the facility. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians dropped a another grenade on him.” He added: “All structures in the settlement is demolished. We see UAVs everywhere and bodies. Our side's and the enemy's.”

The soldier said his unit spent over a month in a forest area close to the city, which enemy forces has been attempting to capture since last year. Sole access to reach their location was by walking. All supplies arrived by drone: rations and drinking water. Seven days following he was hurt, he walked five kilometers (roughly three miles), taking three hours, to a point where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant gave him new non-military attire: a T-shirt and a set of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device ripped a minor injury in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with a head injury. “I was in a dugout. It suddenly went dark. I couldn’t feel any feeling or hear anything,” he explained. “I think I was lucky to survive. A relative has been killed. We face continuous detonations.” A builder employed in Lithuania, Filipchuk noted he had come back to his homeland and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors placed him on a medical cot, took off a stained bandage and cleaned his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his sister. “A fragment of mortar struck me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a few months. After that, to go back to my military group. Someone has to protect our country,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Over the past years, Russia has consistently attacked medical centers, health facilities, maternity wards and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in almost two thousand assaults. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material placed above up to ground level. It is designed to resist impacts from 152mm projectiles and even three eight-kilogram TNT charges dropped by drone.

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 former defence minister, the official, said they would be “critically essential for preserving the lives of our armed forces and assisting troops on the frontline.” The organization referred to the initiative as the “largest-scale and challenging” it had implemented since the enemy's military offensive.

One of the centre’s surgical rooms.

The surgeon, explained some injured personnel had to endure delays many hours or even days before they could be evacuated due to the threat of aerial attacks. “Our facility received two severely injured casualties who arrived at the early hours. It was necessary to perform a removal of both limbs on one of them. The soldier's tourniquet had been on for such an extended period there was no alternative.” How did he cope with traumatic surgeries? “I’ve been medicine for two decades. You have to focus,” he said.

Orderlies wheeled the soldier through the passage and into an ambulance. The vehicle was stationed beneath a shrub. The patient and the other military members were transferred to the urban center of Dnipro for further treatment. The subterranean medical team paused for rest. The facility's ginger cat, the mascot, walked toward the doorway to greet the incoming patients. “We are active 24 hours a day,” the surgeon stated. “The work is continuous.”