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Sparse trees hide the entryway. A sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with beds, heart rate sensors and ventilators. And shelves stocked of healthcare supplies, medications and neat piles of extra garments. In a staff room with a washing machine and hot water heater, physicians keep an eye on a screen. It shows the movements of enemy spy drones as they weave in the sky above.

Medical personnel at an underground hospital look at a screen showing Russian suicide and reconnaissance UAVs in the area.

Welcome to the nation's secret underground hospital. This center began operations in the eighth month and is the second such installation, situated in the eastern part of the country not far from the frontline and the city of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres below the ground. This is the safest method of providing help to our wounded military personnel. And it keeps healthcare workers protected,” said the clinic’s surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point treats 30-40 patients a day. Their conditions vary. Some have catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of Russian FPV aerial devices, which release explosives with lethal precision. “Ninety per cent of our cases are from first-person view drones. We encounter few bullet injuries. It’s an era of unmanned aircraft and a new type of conflict,” the doctor said.

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

During one day last week, a group of three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, reported an FPV blast had torn a minor wound in his leg. “Conflict is horrific. My comrade beside me, Vasyl, was killed,” he stated. “He fell down. Then the Russians dropped a another grenade on him.” He continued: “All structures in the settlement is demolished. There are drones all around and casualties. Our side's and the enemy's.”

Dvorskyi said his squad endured 43 days in a forest area near Pokrovsk, which Russia has been attempting to capture for many months. Sole access to get to their location was by walking. All supplies came by drone: food and water. A week after he was hurt, he walked five kilometers (about 3 miles), taking several hours, to where an military transport was able to pick him up. At the clinic, a medic assessed his physical condition. Following care, a nurse provided him with fresh civilian clothes: a T-shirt and a set of pale jeans.

The soldier, twenty-eight, stated a first-person view drone caused a minor injury in his lower limb.

A different casualty, thirty-eight-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he explained. “I think I was lucky to remain alive. My cousin has been lost. There are continuous detonations.” A builder employed in a neighboring country, Filipchuk said he had come back to his homeland and enlisted to serve shortly before the Russian leader's large-scale attack in February 2022.

Another military member, a serviceman, had been hit in the upper body. He groaned as medical staff placed him on a medical cot, removed a stained dressing and treated his two-day-old shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of mortar struck me. The cause was a ricochet. I’m OK,” he informed her. What comes next for him? “To get better. That will take a several months. After that, to return to my unit. Our forces must protect our nation,” he said.

Doctors treat the wounded soldier, who was hit in the back by a fragment of mortar.

Since 2022, enemy forces has repeatedly attacked hospitals, health facilities, obstetric units and emergency vehicles. According to human rights groups, over two hundred medical personnel have been killed in almost two thousand attacks. The underground facility is constructed from multiple steel bunkers, with timber beams, earth and sand laid on top up to the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple 8kg explosive devices dropped by aerial means.

A major steel and mining company, which financed the construction, plans to erect 20 units in all. The head of the nation's security agency and ex- defence minister, Rustem Umerov, declared they would be “critically important for preserving the survival of our military and assisting troops on the frontline.” The organization described the initiative as the “most ambitious and challenging” it had implemented after the enemy's military offensive.

One of the centre’s surgical rooms.

Holovashchenko, said certain wounded soldiers had to endure delays many hours or even multiple days before they could be evacuated because of the danger of air assaults. “We had a pair of critically ill casualties who arrived at the early hours. I had to carry out a double amputation on one of them. His tourniquet had been applied for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in medicine for 20 years. One must focus,” he said.

Orderlies transported the soldier up the passage and into an emergency vehicle. The vehicle was stationed beneath a shrub. He and the two other military members were taken to the urban center of a major city for additional medical care. The underground medical team paused for rest. The facility's ginger cat, the mascot, walked up to the entrance to await the incoming patients. “Our facility operates open around the clock,” Holovashchenko said. “The work is continuous.”