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Sparse foliage conceal the entrance. A descending timber passageway descends to a well-illuminated welcome zone. There is a surgery unit, outfitted with gurneys, heart rate sensors and ventilators. Plus shelves full of medical equipment, medications and neat piles of extra garments. In a staff room with a washing machine and hot water heater, doctors keep an eye on a screen. The screen reveals the movements of enemy spy drones as they zigzag in the sky above.

Hospital staff at an underground hospital observe a screen displaying enemy kamikaze and reconnaissance drones in the area.

This is Ukraine’s secret underground medical facility. This center began operations in the eighth month and is the second of its kind, situated in eastern Ukraine close to the frontline and the city of a key location in the Donetsk region. “Our facility sits six meters under the ground. This is the safest method of delivering care to our injured soldiers. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Major the chief surgeon.

This medical station treats 30-40 casualties a each day. Their conditions vary. Some have devastating limb trauma necessitating surgical removal, or serious stomach wounds. Some patients can walk. The vast majority are the victims of Russian first-person view (FPV) aerial devices, which drop explosives with deadly precision. “90% of our cases are from first-person view drones. We encounter few gunshot wounds. It’s an era of unmanned aircraft and a different kind of war,” the doctor said.

Maj the senior surgeon at the subterranean facility for treating injured troops in the eastern region.

During one afternoon recently, three soldiers limped into the facility. The most lightly injured, twenty-eight-year-old one soldier, said an FPV blast had torn a small hole in his leg. “Conflict is horrific. My comrade next to me, a fellow soldier, was killed,” he said. “He collapsed. Subsequently the Russians released a second explosive on him.” He added: “All structures in the settlement is demolished. We see drones everywhere and bodies. Ours and theirs.”

Dvorskyi explained his squad spent 43 days in a wooded zone near the city, which enemy forces has been attempting to capture for many months. Sole access to get to their location was on foot. Necessary provisions came by drone: rations and drinking water. Seven days after he was hurt, he walked 5km (about 3 miles), requiring several hours, to 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 civilian clothes: a shirt and a set of light-colored jeans.

The soldier, 28, said a first-person view drone ripped a small hole in his lower limb.

A different casualty, 38-year-old a serviceman, recounted a drone blast had left him with a head injury. “My position was in a trench shelter. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he said. “I think I was lucky to survive. My cousin has been killed. We face continuous explosions.” A construction worker working in Lithuania, Filipchuk said he had come back to Ukraine and volunteered to fight shortly before Vladimir Putin’s large-scale attack in early 2022.

A third soldier, Taras Mykolaichuk, had been hit in the upper body. He groaned as doctors placed him on a bed, removed a bloody dressing and treated his recent shrapnel wound. Wrapped in a thermal sheet, he borrowed a cellphone to ring his sister. “A fragment of artillery struck me. The cause was a ricochet. My condition is stable,” he informed her. What were his plans now? “To get better. That will take a few months. Subsequently, to return to my unit. Someone has to defend our nation,” he said.

Doctors care for the wounded soldier, who was injured in the dorsal area by a fragment of mortar.

Since 2022, Russia has repeatedly targeted hospitals, clinics, obstetric units and ambulances. Per human rights groups, over two hundred health workers have been fatally attacked in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and granular material placed above up to ground level. It can withstand direct hits from 152mm projectiles and even three 8kg TNT charges released by drone.

A major steel and mining company, which funded the construction, plans to erect twenty units in all. The head of the nation's security agency and former military leader, Rustem Umerov, said they would be “vitally essential for preserving the survival of our military and assisting troops on the frontline.” The company described the project as the “most ambitious and demanding” it had undertaken since Russia’s invasion.

One of the facility's operating theatres.

The surgeon, explained certain wounded soldiers had to wait many hours or even multiple days before they could be transported due to the danger of aerial attacks. “Our facility received a pair of critically ill casualties who arrived at 3am. I had to carry out a removal of both limbs on a patient. His tourniquet had been applied for so long there was no other option.” How did he cope with severe surgeries? “I’ve been medicine for 20 years. You have to concentrate,” he remarked.

Medical assistants transported Mykolaichuk up the passage and into an emergency vehicle. The transport was parked under a shrub. He and the two other soldiers were transferred to the urban center of a major city for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, Vasilevs, padded toward the entrance to await the incoming patients. “Our facility operates open 24 hours a day,” the surgeon said. “It doesn’t stop.”