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Sparse foliage hide the entryway. One sloping wooden passageway leads down to a well-illuminated reception area. There is a surgery unit, equipped with gurneys, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, medications and neat piles of extra garments. Within a break area with a washing machine and kettle, doctors monitor a screen. It shows the movements of Russian surveillance UAVs as they zigzag in the air above.

Medical personnel at an underground medical center observe a screen showing Russian suicide and reconnaissance drones in the area.

Welcome to the nation's secret underground hospital. This center opened in the eighth month and is the second such installation, situated in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “We are six meters under the earth. This is the most secure way of delivering care to our wounded soldiers. And it keeps medical personnel safe,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from devastating leg injuries requiring amputations, or severe stomach wounds. Some patients can walk. Almost all are the casualties of enemy first-person view (FPV) aerial devices, which release explosives with deadly accuracy. “90% of our patients are from FPVs. We encounter minimal bullet injuries. It’s an era of drones and a different kind of conflict,” the doctor said.

Maj Oleksandr Holovashchenko at the subterranean facility for treating wounded soldiers in the eastern region.

During one day recently, three soldiers walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had ripped a small hole in his leg. “Conflict is terrible. The guy next to me, Vasyl, was killed,” he said. “He collapsed. Subsequently the Russians dropped a second grenade on him.” He added: “All structures in the settlement is demolished. We see drones all around and bodies. Our side's and the enemy's.”

Dvorskyi explained his squad spent over a month in a forest area near Pokrovsk, which Russia has been trying to seize for many months. The only way to get to their location was by walking. Necessary provisions came by quadcopter: rations and water. Seven days following he was injured, he walked 5km (about 3 miles), requiring three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff checked his physical condition. After treatment, a nurse gave him new non-military attire: a shirt and a pair of light-colored denim trousers.

Artem Dvorskiy, 28, said a first-person view aerial device ripped a small hole in his lower limb.

A different casualty, 38-year-old Pavlo Filipchuk, said a drone blast had left him with a head injury. “I was in a dugout. Suddenly it went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to remain alive. My cousin has been lost. We face ongoing explosions.” A builder working in a neighboring country, he said he had returned to Ukraine and enlisted to fight shortly before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a bloody dressing and cleaned his recent shrapnel wound. Covered in a thermal sheet, he used a cellphone to call his sister. “A fragment of artillery hit me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To recover. This may require a few months. Subsequently, to return to my military group. Our forces has to defend our nation,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Over the past years, enemy forces has consistently targeted hospitals, clinics, maternity wards and ambulances. Per international monitors, 261 medical personnel have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, earth and granular material laid on top up to ground level. It is designed to resist impacts from 152mm artillery shells and even multiple 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which financed the building, intends to erect twenty facilities in total. The head of the nation's security agency and ex- military leader, the official, declared they would be “critically essential for preserving the survival of our armed forces and assisting troops on the battlefront.” The organization referred to the project as the “most ambitious and demanding” it had implemented after Russia’s military offensive.

An example of the centre’s operating theatres.

The surgeon, explained some wounded personnel had to endure delays hours or even multiple days before they could be evacuated because of the threat of air assaults. “We had a pair of critically ill casualties who came at 3am. I had to perform a double amputation on a patient. His bleeding control device had been on for so long there was no other option.” What is his method with traumatic surgeries? “My career in medicine for 20 years. One must concentrate,” he said.

Orderlies wheeled the soldier up the passage and into an ambulance. The vehicle was stationed under a bush. The patient and the other soldiers were transferred to the city of a major city for further treatment. The underground medical team paused for rest. The facility's ginger cat, the mascot, padded up to the entrance to await the next arrivals. “We are open around the clock,” Holovashchenko stated. “It doesn’t stop.”