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Scrubby trees conceal the entryway. One sloping wooden passageway descends to a brightly lit reception area. Inside lies a surgery unit, outfitted with beds, cardiac monitors and breathing machines. And shelves stocked of healthcare supplies, drugs and organized stacks of extra garments. Within a break area with a laundry appliance and kettle, doctors monitor a display. The screen reveals the flight patterns of Russian surveillance UAVs as they zigzag in the air above.

Hospital personnel at an subterranean medical center look at a screen displaying Russian kamikaze and surveillance drones in the region.

This is the nation's covert underground hospital. The facility opened in August and is the second of its kind, located in the eastern part of the country not far from the combat zone and the urban area of Pokrovsk in the Donetsk region. “We are six meters below the earth. This is the most secure way of delivering care to our injured soldiers. And it keeps healthcare workers protected,” stated the facility's surgeon, Maj the chief surgeon.

This medical station treats 30-40 patients a each day. Cases differ widely. Certain individuals suffer from devastating limb trauma necessitating surgical removal, or serious abdominal injuries. Some patients can move on their own. The vast majority are the casualties of enemy FPV aerial devices, which drop explosives with deadly accuracy. “90% of our cases are from first-person view drones. We see minimal gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the surgeon explained.

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

On one afternoon recently, three soldiers limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an first-person view drone explosion had torn a small hole in his limb. “Conflict is terrible. My comrade next to me, a fellow soldier, was killed,” he stated. “He collapsed. Then the enemy forces released a second grenade on him.” He continued: “Everything in the village is demolished. There are UAVs everywhere and casualties. Our side's and the enemy's.”

Dvorskyi explained his squad endured over a month in a wooded zone close to the city, which Russia has been trying to seize since last year. The only way to get to their position was by walking. Necessary provisions arrived by quadcopter: food and water. Seven days after he was injured, he walked 5km (roughly three miles), taking three hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic assessed his physical condition. After treatment, a medical attendant provided him with fresh non-military attire: a T-shirt and a pair of light-colored jeans.

The soldier, twenty-eight, stated a first-person view drone ripped a minor injury in his lower limb.

A different casualty, 38-year-old a serviceman, said a drone blast had resulted in a head injury. “My position was in a dugout. It suddenly went dark. I couldn’t feel anything or any sound,” he explained. “I believe I was fortunate to survive. A relative has been killed. We face continuous explosions.” A builder employed in Lithuania, Filipchuk said he had come back to his homeland and enlisted to serve days before the Russian leader's large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been struck in the upper body. He groaned as medical staff placed him on a medical cot, took off a bloody bandage and treated his recent injury from fragments. Covered in a foil blanket, he used a cellphone to call his sister. “A piece of mortar hit me. The cause was a deflected projectile. My condition is stable,” he informed her. What comes next for him? “To get better. This may require a few months. Subsequently, to return to my military group. Our forces has to defend our country,” he affirmed.

Medical staff treat the wounded soldier, who was hit in the back by a piece of artillery shell.

Since 2022, Russia has repeatedly targeted medical centers, health facilities, obstetric units and emergency vehicles. According to human rights groups, 261 health workers have been fatally attacked in nearly two thousand assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and granular material placed above reaching ground level. It is designed to resist direct hits from 152mm artillery shells and even multiple 8kg TNT charges dropped by drone.

The Ukrainian industrial group, which financed the construction, plans to erect 20 units in all. A senior official of the nation's security agency and former military leader, the official, said they would be “critically essential for preserving the lives of our military and assisting troops on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had implemented after the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, said some injured soldiers had to wait many hours or even days before they could be evacuated because of the threat of aerial attacks. “Our facility received two critically ill casualties who came at the early hours. I had to perform a removal of both limbs on one of them. The soldier's bleeding control device had been applied for such an extended period there was no other option.” How did he cope with traumatic operations? “I’ve been healthcare for 20 years. You have to focus,” he said.

Orderlies wheeled the soldier through the passage and into an emergency vehicle. The vehicle was stationed beneath a bush. He and the two other soldiers were taken to the urban center of a major city for further treatment. The subterranean hospital staff took a break. The hospital’s ginger cat, Vasilevs, padded toward the doorway to greet the next arrivals. “Our facility operates active 24 hours a day,” the surgeon stated. “The work is continuous.”