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Scrubby trees conceal the entrance. One sloping timber passageway descends to a well-illuminated reception area. Inside lies a surgery unit, equipped with beds, heart rate sensors and breathing machines. Plus cabinets stocked of medical equipment, drugs and neat piles of extra garments. Within a break area with a laundry appliance and hot water heater, physicians monitor a screen. The screen reveals the flight patterns of enemy surveillance UAVs as they zigzag in the air above.

Hospital personnel at an underground medical center look at a screen showing Russian suicide and surveillance UAVs in the area.

This is the nation's covert below-ground hospital. The facility 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 6 metres below the ground. It’s the safest method of delivering care to our wounded soldiers. And it keeps healthcare workers safe,” said the facility's surgeon, Maj Oleksandr Holovashchenko.

The stabilisation point handles thirty to forty patients a day. Cases differ widely. Some have catastrophic leg injuries necessitating surgical removal, or severe abdominal injuries. Some patients can move on their own. Almost all are the victims of enemy first-person view (FPV) aerial devices, which release explosives with lethal precision. “90% of our patients are from FPVs. We see few gunshot wounds. This is an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Major the senior surgeon at the subterranean installation for treating injured soldiers in the eastern region.

On one day last week, a group of three military members walked with difficulty into the hospital. The least severely hurt, 28-year-old Artem Dvorskyi, said an first-person view drone blast had torn a small hole in his leg. “Conflict is terrible. The guy next to me, Vasyl, was fatally wounded,” he said. “He collapsed. Then the enemy forces dropped a another explosive on him.” He added: “Everything in the settlement is demolished. We see drones all around and casualties. Our side's and theirs.”

The soldier explained his squad endured over a month in a forest area close to the city, which Russia has been attempting to capture since last year. Sole access to reach their position was by walking. Necessary provisions came by quadcopter: rations and water. A week after he was hurt, he walked five kilometers (roughly three miles), taking several hours, to a point where an military transport was able to pick him up. At the clinic, a medic checked his physical condition. Following care, a medical attendant gave him new civilian clothes: a T-shirt and a pair of pale jeans.

The soldier, 28, said a first-person view aerial device caused a small hole in his leg.

A different casualty, 38-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 couldn’t feel any feeling or hear anything,” he said. “I think I was fortunate to remain alive. A relative has been lost. We face ongoing explosions.” A builder employed in Lithuania, he noted he had returned to his homeland and enlisted to fight shortly before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as medical staff laid him on a medical cot, removed a bloody dressing and cleaned his two-day-old injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to call his family member. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he told her. What were his plans now? “To recover. That will take a few months. Subsequently, to go back to my military group. Someone has to defend our country,” he affirmed.

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

Over the past years, enemy forces has consistently attacked hospitals, clinics, maternity wards and emergency vehicles. According to international monitors, 261 medical personnel have been killed in almost 2,000 attacks. The underground facility is built from four steel bunkers, with timber beams, earth and sand placed above up to ground level. It can withstand impacts from large-caliber artillery shells and even multiple eight-kilogram TNT charges released by drone.

A major steel and mining company, which funded the construction, intends to erect 20 facilities in total. A senior official of the nation's security agency and former defence minister, Rustem Umerov, declared they would be “vitally important for preserving the survival of our military and supporting defenders on the battlefront.” The company described the initiative as the “most ambitious and challenging” it had undertaken since Russia’s invasion.

An example of the centre’s operating theatres.

The surgeon, explained some injured soldiers had to wait hours or even multiple days before they could be evacuated because of the threat of air assaults. “We had a pair of severely injured casualties who arrived at the early hours. I had to carry out a double amputation on one of them. His bleeding control device had been applied for so long there was no alternative.” How did he cope with severe surgeries? “My career in healthcare for 20 years. One must concentrate,” he remarked.

Medical assistants wheeled the soldier up the passage and into an ambulance. The vehicle was parked under a bush. He and the two other military members were taken to the urban center of a major city for further treatment. The subterranean hospital staff paused for rest. The facility's orange feline, Vasilevs, padded up to the entrance to greet the next arrivals. “We are open 24 hours a day,” Holovashchenko stated. “It doesn’t stop.”