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Scrubby foliage hide the entrance. One sloping timber tunnel descends to a well-illuminated welcome zone. There is a surgery unit, equipped with beds, cardiac monitors and ventilators. Plus cabinets stocked of medical equipment, medications and organized stacks of spare clothes. Within a staff room with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the movements of Russian surveillance UAVs as they weave in the sky above.

Medical personnel at an underground hospital look at a monitor showing Russian kamikaze and reconnaissance drones in the area.

Welcome to Ukraine’s secret underground hospital. This center opened in August and is the second such installation, situated in the eastern part of the country not far from the frontline and the urban area of a key location in the Donetsk region. “We are six meters under the earth. It’s the safest way of delivering care to our injured soldiers. It also ensures medical personnel safe,” said the facility's surgeon, Major the chief surgeon.

This medical station treats 30-40 casualties a day. Cases differ widely. Certain individuals suffer from catastrophic limb trauma requiring surgical removal, or serious abdominal injuries. Some patients can move on their own. The vast majority are the victims of Russian FPV aerial devices, which release grenades with lethal precision. “Ninety per cent of our patients are from FPVs. We encounter few gunshot wounds. It’s an era of drones and a different kind of war,” the doctor explained.

Major Oleksandr Holovashchenko at the underground installation for treating injured soldiers in the eastern region.

During one afternoon last week, three military members walked with difficulty into the hospital. The least severely hurt, twenty-eight-year-old Artem Dvorskyi, reported an first-person view drone explosion had ripped a minor wound in his leg. “Conflict is horrific. My comrade beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians dropped a another grenade on him.” He continued: “All structures in the settlement is demolished. We see UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his squad spent 43 days in a forest area close to the city, which Russia has been trying to seize for many months. Sole access to reach their position was on foot. All supplies arrived by quadcopter: food and drinking water. A week after he was hurt, he walked five kilometers (roughly three miles), requiring several hours, to where an armoured vehicle was able to pick him up. At the clinic, a medic assessed his physical condition. After treatment, a medical attendant provided him with fresh non-military attire: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, 28, said a FPV aerial device caused a small hole in his leg.

Another patient, 38-year-old a serviceman, said a UAV explosion had resulted in a head injury. “I was in a dugout. Suddenly it became black. I lost sensation any feeling or any sound,” he said. “I believe I was lucky to remain alive. My cousin has been killed. We face ongoing detonations.” A builder employed in Lithuania, he said he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s full-scale invasion in February 2022.

Another military member, a serviceman, had been struck in the back. He expressed pain as doctors placed him on a medical cot, removed a stained dressing and cleaned his recent injury from fragments. Wrapped in a foil blanket, he used a cellphone to ring his family member. “A piece of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. This may require a few months. Subsequently, to return to my military group. Someone must defend our country,” he affirmed.

Medical staff care for the wounded soldier, who was injured in the back by a piece of mortar.

Over the past years, Russia has consistently attacked medical centers, health facilities, obstetric units and ambulances. According to international monitors, over two hundred medical personnel have been killed in almost two thousand assaults. The underground facility is constructed from four reinforced shelters, with wooden supports, soil and sand laid on top reaching ground level. It can withstand direct hits from 152mm artillery shells and even three 8kg explosive devices released by drone.

The Ukrainian industrial group, which financed the construction, intends to build 20 units in all. The head of the nation's security agency and ex- defence minister, Rustem Umerov, said they would be “critically essential for preserving the survival of our military and supporting troops on the frontline.” The company referred to the initiative as the “largest-scale and challenging” it had implemented since Russia’s invasion.

One of the facility's surgical rooms.

Holovashchenko, explained some wounded soldiers had to wait many hours or even days before they could be transported due to the threat of aerial attacks. “We had two critically ill patients who came at 3am. It was necessary to perform a removal of both limbs on one of them. The soldier's bleeding control device had been applied for so long there was no alternative.” What is his method with severe operations? “I’ve been medicine for 20 years. One must focus,” he remarked.

Medical assistants wheeled the soldier up the passage and into an emergency vehicle. The transport was parked beneath a bush. The patient and the two other military members were transferred to the city of a major city for further treatment. The underground hospital staff paused for rest. The hospital’s orange feline, the mascot, walked toward the entrance to await the next arrivals. “We are open around the clock,” the surgeon said. “The work is continuous.”