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Scrubby foliage hide the entrance. One descending wooden tunnel leads down to a well-illuminated reception area. There is a surgery unit, equipped with gurneys, cardiac monitors and breathing machines. Plus shelves full of medical equipment, drugs and organized stacks of extra garments. In a staff room with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Hospital staff at an underground medical center observe a monitor showing enemy kamikaze and surveillance drones in the region.

This is Ukraine’s covert underground medical facility. This center began operations in the eighth month and is the second such installation, situated in the eastern part of the country close to the frontline and the urban area of a key location in Donetsk oblast. “We are six meters under the earth. This is the safest way of providing help to our injured soldiers. And it keeps medical personnel protected,” stated the facility's lead doctor, Major Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a day. Cases differ widely. Some have catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Others can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “90% of our cases are from first-person view drones. We encounter few bullet injuries. It’s an era of drones and a new type of war,” the surgeon said.

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

On one day recently, three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his leg. “War is horrific. My comrade next to me, Vasyl, was fatally wounded,” he stated. “He collapsed. Subsequently the Russians dropped a another explosive on him.” He added: “All structures in the village is demolished. There are drones everywhere and casualties. Our side's and the enemy's.”

The soldier said his squad spent over a month in a forest area close to the city, which Russia has been trying to seize since last year. The only way to reach their location was by walking. Necessary provisions arrived by drone: rations and drinking water. A week following he was injured, he traveled five kilometers (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his physical condition. Following care, a nurse provided him with fresh non-military attire: a shirt and a set of light-colored jeans.

Artem Dvorskiy, 28, stated a first-person view aerial device caused a small hole in his leg.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in a head injury. “My position was in a trench shelter. Suddenly it became black. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to remain alive. My cousin has been killed. We face continuous detonations.” A construction worker employed in a neighboring country, Filipchuk said he had returned to Ukraine and enlisted to serve days before Vladimir Putin’s large-scale attack in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as doctors laid him on a medical cot, took off a stained dressing and treated his recent injury from fragments. Covered in a foil blanket, he used a cellphone to call his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. This may require a several months. Subsequently, to return to my military group. Our forces must defend our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the back by a piece of artillery shell.

Over the past years, Russia has consistently attacked hospitals, clinics, obstetric units and emergency vehicles. According to international monitors, over two hundred health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, soil and granular material laid on top up to the surface. It can withstand impacts from 152mm projectiles and even multiple eight-kilogram explosive devices released by drone.

A major industrial group, which financed the construction, plans to build twenty units in total. The head of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “critically important for saving the lives of our military and assisting troops on the frontline.” The organization described the initiative as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s surgical rooms.

The surgeon, said certain injured soldiers had to endure delays many hours or even days before they could be evacuated because of the danger of aerial attacks. “We had a pair of critically ill patients who came at 3am. It was necessary to carry out a removal of both limbs on a patient. His tourniquet had been applied for so long there was no other option.” What is his method with severe surgeries? “My career in healthcare for 20 years. One must focus,” he remarked.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The transport was parked under a bush. The patient and the two other military members were transferred to the city of Dnipro for further treatment. The subterranean hospital staff paused for rest. The facility's ginger cat, the mascot, walked toward the doorway to greet the next arrivals. “Our facility operates open around the clock,” the surgeon said. “The work is continuous.”