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Scrubby trees conceal the entrance. A descending wooden passageway leads down to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, cardiac monitors and ventilators. And shelves stocked of medical equipment, medications and neat piles of spare clothes. Within a break area with a laundry appliance and hot water heater, physicians monitor a display. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the sky above.

Medical personnel at an subterranean hospital look at a screen displaying Russian kamikaze and surveillance drones in the region.

This is Ukraine’s secret below-ground hospital. The facility opened in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the city of a key location in Donetsk oblast. “We are 6 metres below the ground. This is the safest method of providing help to our wounded military personnel. And it keeps medical personnel protected,” said the clinic’s surgeon, Major the chief surgeon.

The stabilisation point handles thirty to forty casualties a each day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious stomach wounds. Others can walk. The vast majority are the victims of Russian FPV aerial devices, which release explosives with deadly precision. “90% of our cases are from first-person view drones. We see minimal bullet injuries. It’s an era of drones and a new type of conflict,” the surgeon explained.

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

During one day last week, three soldiers limped into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his leg. “Conflict is terrible. My comrade beside me, a fellow soldier, was killed,” he said. “He fell down. Then the enemy forces released a second explosive on him.” He added: “All structures in the village is demolished. There are drones everywhere and bodies. Our side's and theirs.”

The soldier explained his unit spent over a month in a wooded zone near Pokrovsk, which enemy forces has been attempting to capture since last year. Sole access to get to their position was on foot. Necessary provisions came by quadcopter: rations and drinking water. A week after he was injured, he walked 5km (about 3 miles), taking three hours, to a point where an military transport was able to evacuate him. At the clinic, a medical staff assessed his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a T-shirt and a pair of pale jeans.

Artem Dvorskiy, 28, said a FPV aerial device caused a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it became black. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to survive. A relative has been lost. We face ongoing explosions.” A builder employed in a neighboring country, he said he had returned to Ukraine and volunteered to fight days before the Russian leader's large-scale attack in February 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, took off a bloody bandage and cleaned his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A fragment of artillery struck me. It was a ricochet. I’m OK,” he told her. What were his plans now? “To recover. This may require a few months. After that, to return to my military group. Someone has to protect our nation,” he said.

Doctors treat Taras Mykolaichuk, who was injured in the dorsal area by a fragment of mortar.

Over the past years, Russia has repeatedly targeted medical centers, health facilities, maternity wards and ambulances. According to human rights groups, over two hundred health workers have been fatally attacked in almost two thousand attacks. The underground facility is constructed from multiple reinforced shelters, with wooden supports, soil and granular material laid on top up to ground level. It is designed to resist direct hits from 152mm projectiles and even three 8kg explosive devices dropped by aerial means.

The Ukrainian industrial group, which funded the building, intends to build 20 units in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “vitally essential for saving the lives of our military and supporting troops on the battlefront.” The company referred to the initiative as the “most ambitious and demanding” it had implemented since Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained some injured personnel had to wait many hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had two critically ill patients who came at the early hours. It was necessary to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been on for such an extended period there was no other option.” What is his method with traumatic operations? “My career in medicine for 20 years. You have to focus,” he remarked.

Medical assistants wheeled the soldier through the passage and into an emergency vehicle. The transport was parked under a bush. The patient and the two other soldiers were transferred to the urban center of a major city for further treatment. The underground medical team paused for rest. The facility's orange feline, the mascot, padded toward the doorway to await the incoming patients. “We are open 24 hours a day,” the surgeon stated. “The work is continuous.”