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Scrubby trees conceal the entryway. One sloping timber tunnel leads down to a brightly lit welcome zone. Inside lies a surgery unit, outfitted with beds, heart rate sensors and ventilators. Plus cabinets stocked of medical equipment, medications and organized stacks of spare clothes. In a staff room with a washing machine and hot water heater, physicians monitor a display. It shows the movements of Russian surveillance UAVs as they weave in the air above.

Medical staff at an subterranean hospital observe a screen showing enemy kamikaze and surveillance UAVs in the region.

Welcome to Ukraine’s covert below-ground hospital. This center began operations in August and is the second such installation, located in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “We are six meters under the ground. This is the safest way of delivering care to our wounded soldiers. It also ensures healthcare workers protected,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

The stabilisation point handles 30-40 casualties a day. Cases differ widely. Some have catastrophic leg injuries requiring amputations, or severe abdominal injuries. Others can walk. Almost all are the casualties of enemy FPV aerial devices, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from first-person view drones. We encounter minimal bullet injuries. This is an age of unmanned aircraft and a new type of conflict,” the surgeon explained.

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

On one afternoon recently, three soldiers walked with difficulty into the facility. The most lightly injured, 28-year-old one soldier, reported an first-person view drone blast had ripped a small hole in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he stated. “He fell down. Then the Russians dropped a second grenade on him.” He continued: “Everything in the village is demolished. There are UAVs everywhere and casualties. Ours and the enemy's.”

Dvorskyi explained his squad endured 43 days in a wooded zone near the city, which enemy forces has been trying to seize for many months. The only way to reach their location was on foot. All supplies came by drone: rations and water. Seven days after he was injured, he traveled 5km (about 3 miles), requiring three hours, to a point where an armoured vehicle was able to pick him up. At the clinic, a medical staff assessed his vital signs. Following care, a medical attendant provided him with fresh non-military attire: a shirt and a pair of pale jeans.

The soldier, twenty-eight, said a first-person view drone ripped a minor injury in his leg.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had left him with a head injury. “I was in a dugout. Suddenly it went dark. I lost sensation anything or any sound,” he explained. “I believe I was lucky to remain alive. My cousin has been lost. There are ongoing explosions.” A construction worker employed in a neighboring country, he noted he had come back to his homeland and enlisted to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff laid him on a medical cot, took off a stained dressing and cleaned his two-day-old shrapnel wound. Covered in a thermal sheet, he borrowed a cellphone to call his sister. “A piece of mortar struck me. It was a deflected projectile. My condition is stable,” he told her. What comes next for him? “To get better. This may require a several months. After that, to return to my military group. Our forces has to protect our nation,” he said.

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

Over the past years, Russia has repeatedly targeted hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred health workers have been killed in nearly 2,000 attacks. This subterranean hospital is built from four steel bunkers, with timber beams, earth and sand laid on top reaching the surface. It can withstand direct hits from 152mm projectiles and even multiple 8kg explosive devices released by drone.

A major industrial group, which financed the building, intends to build 20 facilities in all. A senior official of the nation'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 battlefront.” The organization referred to the initiative as the “largest-scale and demanding” it had undertaken since Russia’s military offensive.

One of the centre’s operating theatres.

Holovashchenko, said certain wounded personnel had to wait many hours or even multiple days before they could be transported because of the danger of aerial attacks. “We had a pair of severely injured casualties who arrived at 3am. It was necessary to carry out a removal of both limbs on one of them. His tourniquet had been applied for so long there was no other option.” What is his method with traumatic operations? “I’ve been healthcare for two decades. One must focus,” he said.

Orderlies transported Mykolaichuk through the passage and into an ambulance. The vehicle was stationed under a bush. He and the two other soldiers were transferred to the city of a major city for further treatment. The subterranean medical team took a break. The facility's orange feline, Vasilevs, padded toward the entrance to await the next arrivals. “We are active 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”