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Sparse foliage hide the entryway. One descending timber passageway descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, cardiac monitors and ventilators. And shelves full of medical equipment, medications and organized stacks of extra garments. In a staff room with a laundry appliance and kettle, physicians monitor a display. It shows the flight patterns of enemy surveillance UAVs as they weave in the air above.

Medical staff at an underground hospital observe a screen displaying enemy kamikaze and surveillance drones in the area.

This is the nation's secret below-ground hospital. This center began operations in August and is the second such installation, situated in eastern Ukraine not far from the frontline and the urban area of a key location in the Donetsk region. “We are six meters under the earth. This is the safest way of providing help to our wounded military personnel. And it keeps healthcare workers safe,” said the facility's surgeon, Maj the chief surgeon.

The stabilisation point handles 30-40 casualties a day. Cases differ widely. Certain individuals suffer from catastrophic leg injuries requiring surgical removal, or serious stomach wounds. Others can move on their own. Almost all are the casualties of Russian first-person view (FPV) aerial devices, which release grenades with deadly precision. “Ninety per cent of our patients are from FPVs. We see few gunshot wounds. It’s an era of unmanned aircraft and a new type of war,” the surgeon explained.

Maj Oleksandr Holovashchenko at the subterranean facility for treating injured troops in the eastern region.

During one afternoon recently, a group of three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a small hole in his leg. “Conflict is horrific. My comrade next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a second grenade on him.” He continued: “All structures in the settlement is demolished. We see UAVs all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit spent 43 days in a forest area near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their location was on foot. All supplies arrived by drone: rations and drinking water. A week following he was injured, he walked 5km (roughly three miles), requiring three hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff checked his vital signs. Following care, a medical attendant provided him with new civilian clothes: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, said a FPV drone ripped a minor injury in his lower limb.

Another patient, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “I was in a trench shelter. Suddenly it became black. I lost sensation anything or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been killed. We face ongoing detonations.” A builder working in a neighboring country, Filipchuk said he had returned to his homeland and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as doctors laid him on a bed, removed a bloody bandage and treated his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. That will take a several months. After that, to go back to my unit. Someone must defend our country,” he affirmed.

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

Over the past years, enemy forces has consistently attacked hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in nearly 2,000 assaults. The underground facility is built from four steel bunkers, with wooden supports, soil and sand placed above reaching ground level. It is designed to resist impacts from 152mm projectiles and even multiple 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which financed the construction, plans to erect twenty facilities in all. The head of Ukraine’s security agency and ex- military leader, the official, said they would be “critically essential for saving the survival of our armed forces and assisting troops on the battlefront.” The organization described the project as the “most ambitious and challenging” it had implemented since the enemy's invasion.

One of the facility's surgical rooms.

The surgeon, explained certain injured personnel had to endure delays many hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had a pair of severely injured patients who arrived at 3am. I had to perform a removal of both limbs on one of them. His tourniquet had been applied for such an extended period there was no alternative.” How did he cope with severe operations? “I’ve been healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants transported the soldier up the passage and into an emergency vehicle. The vehicle was stationed under a shrub. He and the other soldiers were taken to the city of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, Vasilevs, walked up to the doorway to await the incoming patients. “We are open around the clock,” the surgeon stated. “It doesn’t stop.”