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Scrubby trees conceal the entrance. One descending timber tunnel leads down to a brightly lit reception area. There is a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. And cabinets full of medical equipment, drugs and neat piles of extra garments. In a break area with a laundry appliance and hot water heater, doctors keep an eye on a screen. The screen reveals the movements of enemy spy drones as they weave in the air above.

Medical personnel at an subterranean medical center look at a monitor displaying enemy kamikaze and surveillance drones in the area.

Welcome to the nation's covert below-ground medical facility. This center opened in the eighth month and is the second such installation, situated in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the earth. It’s the safest method of providing help to our injured soldiers. It also ensures healthcare workers protected,” stated the facility's lead doctor, Major the chief surgeon.

This medical station treats thirty to forty patients a day. Cases differ widely. Some have catastrophic limb trauma requiring amputations, or severe stomach wounds. Some patients can move on their own. Almost all are the victims of Russian first-person view (FPV) aerial devices, which drop grenades with lethal precision. “Ninety per cent of our cases are from first-person view drones. We see few bullet injuries. This is an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Maj the senior surgeon at the underground installation for treating injured troops in eastern Ukraine.

During one day recently, a group of three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, reported an first-person view drone blast had ripped a minor wound in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was killed,” he stated. “He fell down. Subsequently the enemy forces dropped a another grenade on him.” He continued: “All structures in the village is demolished. There are UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his squad spent over a month in a forest area close to the city, which enemy forces has been attempting to capture for many months. The only way to get to their location was on foot. Necessary provisions came by quadcopter: food and drinking water. Seven days after he was injured, he traveled 5km (about 3 miles), taking several hours, to where an military transport was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a nurse provided him with new civilian clothes: a shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a FPV drone ripped a small hole in his leg.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, recounted a UAV explosion had left him with concussion. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel anything or hear anything,” he explained. “I believe I was lucky to survive. A relative has been killed. We face continuous explosions.” A builder employed in Lithuania, he said he had come back to Ukraine and enlisted to fight days before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a bloody dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he borrowed a cellphone to ring his family member. “A piece of artillery struck me. It was a ricochet. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to go back to my unit. Our forces must protect our country,” he said.

Doctors care for the wounded soldier, who was hit in the back by a piece of artillery shell.

Since 2022, Russia has consistently targeted medical centers, health facilities, maternity wards and emergency vehicles. According to international monitors, 261 health workers have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from four reinforced shelters, with wooden supports, earth and sand placed above reaching ground level. It is designed to resist impacts from 152mm projectiles and even multiple 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which funded the building, intends to build 20 facilities in all. The head of Ukraine’s national security council and ex- military leader, Rustem Umerov, declared they would be “vitally essential for saving the lives of our armed forces and supporting defenders on the frontline.” The company described the project as the “most ambitious and demanding” it had implemented since the enemy's military offensive.

One of the centre’s surgical rooms.

The surgeon, said some injured personnel had to wait many hours or even days before they could be evacuated because of the threat of air assaults. “We had two critically ill casualties who came at 3am. It was necessary to perform a double amputation on one of them. His bleeding control device had been on for such an extended period there was no other option.” How did he cope with severe surgeries? “My career in healthcare for two decades. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk through the passage and into an ambulance. The transport was parked beneath a bush. He and the two other military members were transferred to the city of Dnipro for additional medical care. The subterranean hospital staff took a break. The hospital’s orange feline, the mascot, walked toward the entrance to await the incoming patients. “Our facility operates active around the clock,” the surgeon said. “It doesn’t stop.”