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Sparse trees hide the entryway. A sloping wooden tunnel descends to a brightly lit welcome zone. Inside lies a operating ward, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets full of medical equipment, drugs and organized stacks of extra garments. In a staff room with a washing machine and hot water heater, doctors monitor a display. The screen reveals the flight patterns of enemy spy drones as they weave in the sky above.

Hospital personnel at an underground medical center look at a monitor showing Russian suicide and surveillance drones in the region.

This is the nation's covert below-ground medical facility. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine close to the frontline and the city of a key location in the Donetsk region. “We are 6 metres below the ground. This is the most secure method of delivering care to our injured soldiers. And it keeps medical personnel protected,” said the facility's lead doctor, Maj the chief surgeon.

This medical station treats thirty to forty casualties a each day. Their conditions vary. Some have catastrophic leg injuries necessitating surgical removal, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) drones, which drop explosives with deadly precision. “Ninety per cent of our patients are from FPVs. We encounter minimal gunshot wounds. This is an era of drones and a new type of war,” the doctor explained.

Major the senior surgeon at the underground installation for caring for injured troops in eastern Ukraine.

On one day last week, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a minor wound in his leg. “Conflict is terrible. The guy next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a second explosive on him.” He continued: “Everything in the settlement is demolished. We see drones all around and bodies. Ours and the enemy's.”

The soldier said his unit endured 43 days in a wooded zone near Pokrovsk, which Russia has been attempting to capture for many months. Sole access to get to their location was on foot. Necessary provisions came by quadcopter: food and water. Seven days following he was hurt, he walked 5km (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a nurse provided him with fresh civilian clothes: a shirt and a set of light-colored denim trousers.

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

Another patient, thirty-eight-year-old a serviceman, recounted a drone blast had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or any sound,” he explained. “I think I was fortunate to remain alive. A relative has been killed. We face continuous explosions.” A builder working in Lithuania, he said he had returned to his homeland and enlisted to serve shortly before Vladimir Putin’s full-scale invasion in early 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff placed him on a medical cot, took off a bloody bandage and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his sister. “A fragment of artillery hit me. The cause was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. That will take a few months. Subsequently, to return to my military group. Someone must defend our nation,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, Russia has repeatedly attacked hospitals, health facilities, obstetric units and ambulances. Per international monitors, over two hundred health workers have been fatally attacked in almost 2,000 attacks. This subterranean hospital is built from four steel bunkers, with wooden supports, soil and granular material laid on top up to ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg explosive devices dropped by aerial means.

A major industrial group, which funded the construction, intends to erect twenty facilities in total. A senior official of the nation's security agency and former military leader, Rustem Umerov, declared they would be “vitally essential for preserving the survival of our military and assisting defenders on the battlefront.” The company referred to the initiative as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

One of the facility's surgical rooms.

Holovashchenko, explained some injured personnel had to endure delays hours or even days before they could be evacuated because of the danger of aerial attacks. “We had two critically ill casualties who arrived at the early hours. I had to perform a double amputation on one of them. His bleeding control device had been applied for such an extended period there was no alternative.” What is his method with traumatic surgeries? “My career in medicine for two decades. One must concentrate,” he remarked.

Orderlies wheeled the soldier up the passage and into an ambulance. The transport was stationed under a shrub. He and the other soldiers were transferred to the city of a major city for additional medical care. The subterranean medical team took a break. The hospital’s ginger cat, the mascot, padded toward the entrance to await the next arrivals. “Our facility operates active around the clock,” Holovashchenko stated. “The work is continuous.”