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Scrubby trees hide the entrance. A descending timber tunnel descends to a brightly lit welcome zone. There is a operating ward, outfitted with beds, heart rate sensors and ventilators. Plus shelves full of medical equipment, drugs and organized stacks of spare clothes. In a break area with a laundry appliance and kettle, doctors monitor a screen. It shows the movements of enemy surveillance UAVs as they weave in the air above.

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

Welcome to the nation's covert below-ground hospital. The facility began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the city of a key location in Donetsk oblast. “We are six meters below the earth. This is the most secure method of delivering care to our injured soldiers. And it keeps medical personnel safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles 30-40 patients a day. Their conditions vary. Certain individuals suffer from devastating leg injuries necessitating surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the casualties of Russian FPV drones, which drop grenades with lethal precision. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. This is an era of drones and a different kind of war,” the surgeon said.

Major Oleksandr Holovashchenko at the underground installation for caring for wounded soldiers in eastern Ukraine.

During one day last week, three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV explosion had torn a minor wound in his limb. “Conflict is horrific. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the Russians released a another explosive on him.” He continued: “All structures in the village is destroyed. We see UAVs all around and casualties. Ours and the enemy's.”

The soldier explained his unit endured 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. All supplies arrived by drone: food and water. Seven days following he was injured, he traveled five kilometers (roughly three miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic assessed his vital signs. Following care, a nurse gave him fresh non-military attire: a T-shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV drone ripped a minor injury in his leg.

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had left him with concussion. “I was in a dugout. Suddenly it became black. I couldn’t feel any feeling or hear anything,” he said. “I believe I was lucky to remain alive. A relative has been lost. There are continuous detonations.” A construction worker working in a neighboring country, he said he had come back to his homeland and enlisted to fight days before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a medical cot, removed a bloody bandage and treated his two-day-old injury from fragments. Wrapped in a foil blanket, he used a mobile phone to call his family member. “A piece of mortar struck me. It was a deflected projectile. My condition is stable,” he informed her. What were his plans now? “To recover. That will take a several months. After that, to go back to my military group. Someone has to protect our nation,” he affirmed.

Doctors care for the wounded soldier, who was injured in the back by a fragment of artillery shell.

Over the past years, enemy forces has consistently attacked medical centers, clinics, obstetric units and emergency vehicles. Per human rights groups, over two hundred health workers have been fatally attacked in almost 2,000 attacks. The underground facility is constructed from multiple reinforced shelters, with timber beams, earth and sand placed above up to the surface. It can withstand impacts from large-caliber projectiles and even three 8kg TNT charges released by drone.

The Ukrainian industrial group, which financed the construction, intends to erect twenty units in all. The head of the nation's security agency and former military leader, Rustem Umerov, said they would be “critically essential for preserving the lives of our armed forces and assisting defenders on the battlefront.” The organization referred to the initiative as the “largest-scale and demanding” it had undertaken after the enemy's invasion.

One of the centre’s operating theatres.

Holovashchenko, said some wounded personnel had to endure delays hours or even days before they could be transported because of the threat of air assaults. “We had two severely injured casualties who arrived at 3am. I had to carry out a double amputation on one of them. His bleeding control device had been applied for so long there was no other option.” How did he cope with traumatic operations? “My career in healthcare for 20 years. One must concentrate,” he said.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The vehicle was stationed under a shrub. He and the other soldiers were transferred to the city of Dnipro for additional medical care. The subterranean medical team took a break. The facility's ginger cat, the mascot, padded up to the doorway to await the incoming patients. “Our facility operates active 24 hours a day,” Holovashchenko said. “It doesn’t stop.”