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Scrubby foliage hide the entryway. A sloping timber tunnel leads down to a brightly lit reception area. There is a surgery unit, outfitted with beds, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, drugs and neat piles of spare clothes. In a staff room with a washing machine and hot water heater, physicians keep an eye on a display. It shows the movements of enemy spy drones as they weave in the air above.

Hospital personnel at an subterranean hospital observe a monitor displaying enemy kamikaze and surveillance UAVs in the area.

Welcome to the nation's secret underground hospital. The facility opened in the eighth month and is the second such installation, situated in the eastern part of the country close to the combat zone and the city of a key location in the Donetsk region. “Our facility sits six meters below the ground. This is the most secure method of delivering care to our injured military personnel. It also ensures healthcare workers safe,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

This medical station treats 30-40 casualties a each day. Their conditions vary. Some have catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Others can walk. The vast majority are the casualties of enemy first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon said.

Major the senior surgeon at the subterranean facility for treating injured soldiers in eastern Ukraine.

During one day last week, a group of three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, said an first-person view drone explosion had torn a minor wound in his limb. “Conflict is terrible. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He fell down. Then the enemy forces released a another explosive on him.” He continued: “Everything in the settlement is destroyed. We see drones all around and casualties. Ours and the enemy's.”

The soldier said his unit spent 43 days in a forest area near the city, which enemy forces has been attempting to capture for many months. The only way to get to their position was on foot. All supplies came by drone: food and drinking water. Seven days after he was injured, he traveled five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medical staff assessed his vital signs. After treatment, a medical attendant gave him new non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, stated a first-person view aerial device caused a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, said a UAV explosion had resulted in concussion. “My position was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or hear anything,” he explained. “I believe I was fortunate to survive. A relative has been killed. There are ongoing detonations.” A construction worker employed in Lithuania, Filipchuk noted he had returned to his homeland and enlisted to serve shortly before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a bed, removed a stained bandage and cleaned his recent shrapnel wound. Covered in a foil blanket, he borrowed a mobile phone to ring his sister. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to go back to my military group. Someone has to defend our country,” he affirmed.

Doctors treat Taras Mykolaichuk, who was injured in the back by a piece of artillery shell.

Over the past years, enemy forces has repeatedly targeted medical centers, clinics, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been killed in almost 2,000 attacks. The underground facility is built from four reinforced shelters, with wooden supports, earth and granular material laid on top up to the surface. It is designed to resist impacts from 152mm projectiles and even three 8kg TNT charges released by drone.

The Ukrainian industrial group, which financed the building, intends to build twenty units in total. The head of the nation's national security council and ex- defence minister, the official, declared they would be “vitally important for preserving the lives of our armed forces and assisting troops on the frontline.” The organization described the project as the “most ambitious and demanding” it had undertaken since Russia’s military offensive.

One of the centre’s surgical rooms.

Holovashchenko, said certain injured soldiers had to endure delays hours or even multiple days before they could be transported due to the danger of aerial attacks. “We had a pair of critically ill patients who came at 3am. I had to perform a removal of both limbs on one of them. His tourniquet had been on for such an extended period there was no alternative.” What is his method with severe operations? “I’ve been healthcare for 20 years. You have to focus,” he said.

Medical assistants transported Mykolaichuk up the passage and into an emergency vehicle. The vehicle was parked beneath a shrub. The patient and the other military members were transferred to the urban center of Dnipro for further treatment. The subterranean hospital staff paused for rest. The facility's ginger cat, the mascot, walked up to the doorway to greet the next arrivals. “Our facility operates active 24 hours a day,” the surgeon stated. “It doesn’t stop.”