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Sparse foliage conceal the entrance. One sloping timber tunnel leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with beds, cardiac monitors and ventilators. Plus shelves stocked of medical equipment, drugs and organized stacks of extra garments. Within a staff room with a washing machine and kettle, physicians keep an eye on a screen. It shows the flight patterns of Russian spy drones as they zigzag in the air above.

Hospital staff at an underground hospital look at a screen showing Russian suicide and surveillance drones in the region.

Welcome to the nation's secret below-ground hospital. The facility opened in the eighth month and is the second such installation, situated in eastern Ukraine close to the combat zone and the urban area of a key location in the Donetsk region. “We are six meters below the earth. This is the safest method of delivering care to our wounded soldiers. And it keeps medical personnel protected,” said the clinic’s lead doctor, Maj Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty casualties a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian first-person view (FPV) drones, which release explosives with lethal accuracy. “90% of our patients are from first-person view drones. We encounter few bullet injuries. It’s an age of unmanned aircraft and a new type of conflict,” the doctor explained.

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

On one day last week, a group of three military members limped into the facility. The most lightly injured, 28-year-old one soldier, reported an FPV blast had ripped 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 Russians dropped a another grenade on him.” He added: “Everything in the settlement is demolished. There are UAVs all around and bodies. Ours and the enemy's.”

The soldier said his unit endured over a month in a wooded zone near the city, which enemy forces has been trying to seize since last year. Sole access to reach their location was by walking. All supplies arrived by drone: rations and drinking water. A week following he was hurt, he traveled five kilometers (about 3 miles), requiring several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of pale denim trousers.

The soldier, 28, said a FPV aerial device ripped a minor injury in his leg.

Another patient, 38-year-old Pavlo Filipchuk, recounted a UAV explosion had resulted in concussion. “I was in a trench shelter. It suddenly went dark. I lost sensation anything or hear anything,” he said. “I think I was lucky to remain alive. A relative has been killed. There are continuous detonations.” A builder working in Lithuania, he said he had come back to Ukraine and enlisted to fight days before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the back. He groaned as doctors laid him on a medical cot, removed a stained dressing and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to ring his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To recover. That will take a several months. After that, to return to my unit. Our forces has to defend our country,” he said.

Doctors care for Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Over the past years, Russia has repeatedly attacked hospitals, clinics, maternity wards and ambulances. Per international monitors, 261 health workers have been killed in nearly two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with wooden supports, soil and granular material placed above up to ground level. It can withstand impacts from large-caliber artillery shells and even three 8kg TNT charges released by drone.

The Ukrainian steel and mining company, which funded the building, intends to erect 20 facilities in total. A senior official of Ukraine’s security agency and former military leader, the official, declared they would be “vitally essential for saving the lives of our military and supporting defenders on the frontline.” The organization referred to the project as the “most ambitious and demanding” it had undertaken after Russia’s invasion.

One of the centre’s surgical rooms.

Holovashchenko, said certain wounded personnel had to endure delays many hours or even multiple days before they could be evacuated because of the danger of air assaults. “We had two severely injured patients who arrived at 3am. I had to perform a removal of both limbs on a patient. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with traumatic surgeries? “My career in medicine for 20 years. One must concentrate,” he said.

Medical assistants wheeled Mykolaichuk up the passage and into an ambulance. The vehicle was stationed under a shrub. The patient and the two other soldiers were transferred to the city of Dnipro for additional medical care. The subterranean medical team paused for rest. The hospital’s orange feline, Vasilevs, walked toward the doorway to await the incoming patients. “Our facility operates active around the clock,” Holovashchenko said. “The work is continuous.”