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Scrubby foliage conceal the entrance. One sloping wooden passageway leads down to a well-illuminated reception area. There is a surgery unit, outfitted with beds, heart rate sensors and breathing machines. Plus cabinets full of medical equipment, medications and organized stacks of extra garments. Within a staff room with a laundry appliance and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Medical staff at an subterranean medical center look at a monitor displaying Russian kamikaze and reconnaissance UAVs in the area.

This is Ukraine’s covert underground hospital. The facility opened in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of a key location in the Donetsk region. “Our facility sits 6 metres below the ground. This is the safest way of providing help to our wounded military personnel. It also ensures healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station treats thirty to forty patients a each day. Their conditions vary. Some have devastating leg injuries requiring amputations, or severe stomach wounds. Others can walk. Almost all are the victims of Russian first-person view (FPV) drones, which release grenades with lethal precision. “Ninety per cent of our cases are from first-person view drones. We encounter few gunshot wounds. This is an age of drones and a different kind of conflict,” the surgeon explained.

Major the senior surgeon at the subterranean installation for treating wounded soldiers in eastern Ukraine.

On one day recently, a group of three soldiers limped into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an FPV explosion had torn a minor wound in his leg. “War is terrible. My comrade next to me, a fellow soldier, was killed,” he said. “He fell down. Subsequently the Russians released a second grenade on him.” He added: “Everything in the settlement is demolished. There are UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his squad spent 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. The only way to get to their location was on foot. All supplies came by drone: food and drinking water. Seven days following he was hurt, he traveled 5km (roughly three miles), taking several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic checked his vital signs. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a set of pale jeans.

Artem Dvorskiy, 28, said a FPV aerial device ripped a small hole in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted a drone blast had left him with concussion. “My position was in a dugout. It suddenly went dark. I lost sensation any feeling or any sound,” he explained. “I believe I was lucky to survive. My cousin has been lost. We face continuous detonations.” A construction worker employed in a neighboring country, Filipchuk said he had come back to Ukraine and enlisted to serve days before the Russian leader's large-scale attack in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff placed him on a medical cot, took off a stained dressing and treated his two-day-old shrapnel wound. Covered in a foil blanket, he used a cellphone to ring his sister. “A fragment of mortar struck me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. This may require a several months. Subsequently, to go back to my unit. Someone has to protect our country,” he said.

Medical staff care for Taras Mykolaichuk, who was injured in the back by a fragment of mortar.

Over the past years, Russia has consistently targeted medical centers, clinics, obstetric units and emergency vehicles. Per human rights groups, over two hundred medical personnel have been killed in nearly two thousand assaults. This subterranean hospital is constructed from multiple reinforced shelters, with timber beams, earth and granular material laid on top reaching ground level. It is designed to resist impacts from 152mm projectiles and even multiple eight-kilogram explosive devices released by aerial means.

A major steel and mining company, which funded the building, plans to build 20 units in all. A senior official of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “critically important for saving the survival of our armed forces and assisting defenders on the frontline.” The company described the initiative as the “largest-scale and challenging” it had undertaken since Russia’s military offensive.

An example of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to wait hours or even days before they could be evacuated because of the danger of aerial attacks. “Our facility received a pair of severely injured patients who came at the early hours. It was necessary to carry out a removal of both limbs on one of them. The soldier's tourniquet had been applied for such an extended period there was no alternative.” How did he cope with traumatic operations? “I’ve been healthcare for two decades. One must concentrate,” he remarked.

Medical assistants wheeled Mykolaichuk through the passage and into an emergency vehicle. The vehicle was stationed under a shrub. He and the other soldiers were transferred to the urban center of Dnipro for additional medical care. The underground hospital staff took a break. The facility's orange feline, Vasilevs, walked toward the entrance to await the incoming patients. “We are open around the clock,” the surgeon stated. “The work is continuous.”