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Sparse trees conceal the entryway. One descending timber passageway descends to a brightly lit reception area. There is a operating ward, outfitted with beds, heart rate sensors and breathing machines. And cabinets full of medical equipment, drugs and neat piles of extra garments. Within a staff room with a laundry appliance and hot water heater, doctors monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital personnel at an subterranean medical center observe a monitor displaying enemy kamikaze and surveillance drones in the area.

Welcome to the nation's covert below-ground hospital. This center opened in August and is the second such installation, situated in eastern Ukraine not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “Our facility sits six meters below the earth. This is the most secure way of delivering care to our injured soldiers. It also ensures healthcare workers protected,” said the facility's surgeon, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Some have catastrophic leg injuries requiring amputations, or serious abdominal injuries. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) drones, which release explosives with lethal accuracy. “90% of our patients are from FPVs. We see minimal bullet injuries. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

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

During one afternoon recently, a group of three military members limped into the hospital. The least severely hurt, twenty-eight-year-old one soldier, reported an first-person view drone explosion had torn a minor wound in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he said. “He collapsed. Then the Russians dropped a second grenade on him.” He continued: “Everything in the village is destroyed. There are UAVs all around and bodies. Ours and the enemy's.”

Dvorskyi explained his squad endured 43 days in a forest area near the city, which Russia has been trying to seize for many months. Sole access to reach their position was on foot. Necessary provisions arrived by drone: rations and drinking water. Seven days following he was injured, he walked five kilometers (about 3 miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. After treatment, a medical attendant gave him new civilian clothes: a shirt and a set of light-colored denim trousers.

The soldier, 28, said a first-person view drone caused a minor injury in his lower limb.

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had left him with a head injury. “My position was in a dugout. It suddenly became black. I couldn’t feel anything or any sound,” he explained. “I think I was lucky to remain alive. A relative has been lost. There are ongoing detonations.” A builder working in a neighboring country, Filipchuk said he had come back to his homeland and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff laid him on a medical cot, removed a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he used a cellphone to ring his family member. “A fragment of artillery struck me. The cause was a ricochet. I’m OK,” he told her. What comes next for him? “To recover. This may require a several months. Subsequently, to return to my unit. Someone must defend our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, enemy forces has consistently attacked medical centers, health facilities, obstetric units and ambulances. According to international monitors, over two hundred health workers have been fatally attacked in nearly 2,000 attacks. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and sand placed above up to ground level. It is designed to resist impacts from large-caliber projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, plans to build 20 facilities in total. The head of Ukraine’s national security council and former defence minister, the official, said they would be “critically essential for saving the survival of our military and assisting troops on the battlefront.” The organization described the initiative as the “most ambitious and challenging” it had implemented since the enemy's invasion.

One of the facility's operating theatres.

The surgeon, said some wounded soldiers had to wait many hours or even days before they could be transported due to the threat of air assaults. “Our facility received a pair of severely injured casualties who arrived at 3am. It was necessary to perform a double amputation on one of them. The soldier's bleeding control device had been on for so long there was no alternative.” What is his method with severe surgeries? “My career in healthcare for two decades. One must concentrate,” he remarked.

Orderlies transported Mykolaichuk through the tunnel and into an emergency vehicle. The transport was stationed under a shrub. The patient and the two other soldiers were taken to the city of a major city for additional medical care. The subterranean hospital staff took a break. The facility's orange feline, the mascot, padded toward the entrance to greet the incoming patients. “We are open 24 hours a day,” the surgeon said. “The work is continuous.”