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Sparse foliage hide the entrance. One descending wooden tunnel descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, medications and organized stacks of spare clothes. In a break area with a washing machine and hot water heater, doctors monitor a screen. The screen reveals the flight patterns of Russian spy drones as they weave in the air above.

Hospital staff at an underground hospital look at a monitor showing enemy suicide and surveillance UAVs in the region.

Welcome to Ukraine’s secret below-ground hospital. The facility opened in the eighth month and is the second such installation, located in eastern Ukraine not far from the combat zone and the urban area of a key location in the Donetsk region. “We are six meters below the earth. It’s the safest method of providing help to our injured soldiers. And it keeps medical personnel protected,” said the facility's lead doctor, Maj the chief surgeon.

This medical station treats thirty to forty casualties a each day. Their conditions vary. Certain individuals suffer from catastrophic limb trauma necessitating surgical removal, or serious stomach wounds. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which release explosives with lethal precision. “Ninety per cent of our patients are from first-person view drones. We encounter minimal gunshot wounds. This is an era of unmanned aircraft and a new type of conflict,” the surgeon said.

Major the senior surgeon at the subterranean installation for treating wounded troops in the eastern region.

On one day recently, three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an first-person view drone explosion had ripped a small hole in his limb. “War is terrible. My comrade beside me, a fellow soldier, was killed,” he stated. “He fell down. Then the Russians dropped a another explosive on him.” He continued: “Everything in the settlement is demolished. There are drones all around and bodies. Our side's and theirs.”

Dvorskyi explained his squad endured 43 days 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 position was on foot. All supplies came by quadcopter: food and drinking water. A week after he was injured, he traveled five kilometers (roughly three miles), taking several hours, to where an military transport was able to evacuate him. At the clinic, a medic assessed his vital signs. Following care, a nurse provided him with fresh non-military attire: a shirt and a pair of light-colored denim trousers.

The soldier, 28, stated a FPV drone ripped a small hole in his leg.

A different casualty, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation anything or any sound,” he said. “I think I was fortunate to remain alive. My cousin has been killed. There are continuous explosions.” A construction worker working in a neighboring country, Filipchuk said he had come back to Ukraine and enlisted to fight days before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He groaned as medical staff laid him on a medical cot, removed a stained bandage and cleaned his two-day-old shrapnel wound. Wrapped in a foil blanket, he used a mobile phone to call his family member. “A piece of artillery struck me. The cause was a deflected projectile. My condition is stable,” he told her. What were his plans now? “To get better. This may require a few months. After that, to return to my military group. Our forces must protect our country,” he said.

Doctors treat Taras Mykolaichuk, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has consistently attacked hospitals, health facilities, obstetric units and ambulances. Per human rights groups, over two hundred medical personnel have been fatally attacked in nearly 2,000 attacks. The underground facility is built from four steel bunkers, with wooden supports, soil and sand placed above up to the surface. It can withstand impacts from large-caliber artillery shells and even multiple eight-kilogram explosive devices dropped by aerial means.

The Ukrainian industrial group, which funded the construction, intends to erect twenty units in all. A senior official of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “vitally essential for saving the survival of our armed forces and supporting defenders on the frontline.” The company referred to the project as the “largest-scale and demanding” it had implemented after Russia’s military offensive.

An example of the facility's surgical rooms.

The surgeon, explained certain injured soldiers had to wait many hours or even days before they could be transported because of the threat of aerial attacks. “We had a pair of severely injured casualties who came at 3am. It was necessary to carry out a double amputation on one of them. His tourniquet had been on for such an extended period there was no alternative.” How did he cope with severe operations? “My career in medicine for two decades. One must focus,” he said.

Medical assistants wheeled Mykolaichuk through the tunnel and into an emergency vehicle. The transport was parked beneath a shrub. He and the two other soldiers were transferred to the urban center of Dnipro for further treatment. The underground hospital staff paused for rest. The facility's orange feline, the mascot, padded toward the entrance to await the next arrivals. “Our facility operates open 24 hours a day,” the surgeon stated. “It doesn’t stop.”