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Scrubby foliage hide the entryway. A sloping wooden tunnel leads down to a well-illuminated reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. Plus shelves full of medical equipment, medications and neat piles of spare clothes. In a break area with a laundry appliance and hot water heater, doctors keep an eye on a display. The screen reveals the movements of Russian spy drones as they zigzag in the sky above.

Medical staff at an subterranean hospital observe a screen showing Russian kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s covert underground hospital. The facility opened in the eighth month and is the second of its kind, located in eastern Ukraine not far from the combat zone and the urban area of a key location in the Donetsk region. “We are 6 metres below the ground. It’s the most secure method of providing help to our injured soldiers. And it keeps healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station treats 30-40 patients a each day. Their conditions vary. Some have catastrophic limb trauma requiring surgical removal, or severe abdominal injuries. Some patients can walk. Almost all are the victims of enemy first-person view (FPV) drones, which release explosives with deadly accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter few 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 soldiers in eastern Ukraine.

During one day last week, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV explosion had torn a small hole in his leg. “War is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He fell down. Then the enemy forces dropped a another explosive on him.” He continued: “All structures in the village is demolished. We see UAVs everywhere and casualties. Ours and theirs.”

Dvorskyi said his unit endured over a month in a wooded zone near Pokrovsk, which Russia has been attempting to capture since last year. Sole access to get to their location was by walking. All supplies arrived by drone: food and drinking water. A week after he was hurt, he walked 5km (about 3 miles), requiring three hours, to where an military transport was able to evacuate him. Upon arrival, a medic checked his vital signs. After treatment, a nurse gave him fresh civilian clothes: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, stated a first-person view aerial device ripped a small hole in his leg.

Another patient, thirty-eight-year-old a serviceman, said a drone blast had resulted in a head injury. “My position was in a trench shelter. It suddenly went dark. I couldn’t feel anything or any sound,” he said. “I believe I was lucky to survive. A relative has been lost. There are continuous explosions.” A builder employed in Lithuania, he said he had come back to Ukraine and enlisted to serve shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a bed, removed a bloody dressing and treated his recent shrapnel wound. Covered in a thermal sheet, he used a mobile phone to ring his family member. “A piece of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To get better. That will take a few months. Subsequently, to return to my unit. Someone has to defend our nation,” he said.

Medical staff treat Taras Mykolaichuk, who was injured in the back by a piece of mortar.

Over the past years, Russia has repeatedly targeted hospitals, health facilities, maternity wards and ambulances. According to human rights groups, over two hundred medical personnel have been killed in almost two thousand attacks. This subterranean hospital is built from four steel bunkers, with timber beams, earth and granular material laid on top up to ground level. It is designed to resist impacts from large-caliber projectiles and even multiple 8kg explosive devices released by aerial means.

A major steel and mining company, which financed the construction, plans to erect 20 facilities in total. The head of Ukraine’s national security council and ex- military leader, the official, said they would be “critically important for preserving the survival of our military and supporting defenders on the frontline.” The organization referred to the project as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

One of the facility's operating theatres.

The surgeon, explained some wounded personnel had to endure delays many hours or even multiple days before they could be evacuated because of the danger of air assaults. “Our facility received two severely injured casualties who came at 3am. I had to carry out a double amputation on one of them. The soldier's tourniquet had been applied for so long there was no alternative.” What is his method with severe operations? “My career in healthcare for 20 years. You have to focus,” he remarked.

Orderlies transported the soldier up the tunnel and into an ambulance. The transport was stationed under a shrub. The patient and the two other soldiers were taken to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The hospital’s orange feline, Vasilevs, walked up to the doorway to await the incoming patients. “We are open 24 hours a day,” the surgeon stated. “It doesn’t stop.”