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Scrubby trees conceal the entryway. One descending wooden tunnel leads down to a well-illuminated welcome zone. There is a surgery unit, equipped with gurneys, cardiac monitors and ventilators. And cabinets stocked of medical equipment, medications and neat piles of extra garments. Within a break area with a laundry appliance and kettle, physicians monitor a screen. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Hospital staff at an subterranean hospital observe a monitor showing Russian kamikaze and surveillance UAVs in the area.

Welcome to the nation's covert underground hospital. The facility began operations in the eighth month and is the second of its kind, located in eastern Ukraine close to the combat zone and the city of Pokrovsk in the Donetsk region. “We are six meters below the ground. It’s the safest way of providing help to our injured soldiers. And it keeps healthcare workers safe,” said the clinic’s lead doctor, Maj the chief surgeon.

This medical station handles thirty to forty casualties a day. Cases differ widely. Some have devastating leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which release grenades with lethal accuracy. “Ninety per cent of our patients are from FPVs. We see few gunshot wounds. This is an era of drones and a new type of conflict,” the surgeon explained.

Maj the senior surgeon at the underground installation for caring for wounded soldiers in the eastern region.

During one day last week, three soldiers limped into the hospital. The least severely hurt, 28-year-old one soldier, reported an FPV explosion had ripped a minor wound in his leg. “War is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the enemy forces released a second explosive on him.” He continued: “Everything in the settlement is destroyed. We see UAVs everywhere and bodies. Ours and theirs.”

The soldier said his unit endured 43 days in a wooded zone close to Pokrovsk, which enemy forces has been trying to seize since last year. Sole access to get to their location was on foot. All supplies arrived by drone: food and water. Seven days after he was hurt, he traveled 5km (about 3 miles), taking several hours, to where an armoured vehicle was able to evacuate him. Upon arrival, a medic checked his vital signs. After treatment, a nurse gave him new non-military attire: a T-shirt and a set of pale denim trousers.

Artem Dvorskiy, twenty-eight, said a first-person view aerial device caused a small hole in his lower limb.

Another patient, thirty-eight-year-old a serviceman, said a drone blast had resulted in concussion. “My position was in a trench shelter. It suddenly went dark. I lost sensation any feeling or any sound,” he said. “I believe I was fortunate to remain alive. A relative has been killed. There are ongoing detonations.” A construction worker working in a neighboring country, Filipchuk said he had come back to Ukraine and volunteered to fight days before Vladimir Putin’s full-scale invasion in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He groaned as medical staff laid him on a bed, took off a stained bandage and treated his two-day-old injury from fragments. Covered in a thermal sheet, he borrowed a mobile phone to call his sister. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What were his plans now? “To get better. This may require a several months. After that, to go back to my military group. Our forces must protect our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the dorsal area by a fragment of artillery shell.

Since 2022, Russia has repeatedly attacked hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, 261 health workers have been fatally attacked in nearly two thousand attacks. This subterranean hospital is built from multiple reinforced shelters, with timber beams, earth and sand laid on top reaching the surface. It is designed to resist direct hits from large-caliber projectiles and even three eight-kilogram TNT charges dropped by aerial means.

The Ukrainian industrial group, which financed the construction, plans to build 20 facilities in total. A senior official of Ukraine’s national security council and ex- defence minister, Rustem Umerov, said they would be “vitally important for saving the survival of our military and assisting defenders on the frontline.” The organization referred to the initiative as the “largest-scale and demanding” it had implemented after Russia’s invasion.

An example of the centre’s surgical rooms.

The surgeon, explained certain wounded soldiers had to endure delays hours or even days before they could be evacuated because of the threat of air assaults. “We had two critically ill patients who arrived at 3am. I had to perform a double amputation on a patient. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” What is his method with severe surgeries? “My career in medicine for two decades. One must concentrate,” he remarked.

Orderlies wheeled the soldier through the tunnel and into an emergency vehicle. The transport was parked under a bush. The patient and the other soldiers were taken to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The facility's orange feline, the mascot, padded toward the entrance to greet the incoming patients. “We are open around the clock,” the surgeon stated. “The work is continuous.”