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Sparse foliage conceal the entryway. A descending wooden tunnel leads down to a brightly lit welcome zone. Inside lies a operating ward, equipped with gurneys, heart rate sensors and breathing machines. Plus cabinets full of healthcare supplies, medications and neat piles of extra garments. In a staff room with a washing machine and hot water heater, physicians monitor a display. The screen reveals the movements of enemy spy drones as they weave in the sky above.

Hospital staff at an subterranean hospital look at a screen showing enemy suicide and reconnaissance drones in the area.

This is Ukraine’s covert below-ground hospital. This center began operations in August and is the second such installation, located in eastern Ukraine close to the combat zone and the urban area of Pokrovsk in Donetsk oblast. “We are six meters under the earth. This is the most secure method of delivering care to our injured soldiers. And it keeps healthcare workers protected,” said the clinic’s lead doctor, Major Oleksandr Holovashchenko.

The stabilisation point treats thirty to forty patients a each day. Their conditions vary. Some have catastrophic limb trauma necessitating amputations, or severe abdominal injuries. Others can walk. Almost all are the casualties of Russian FPV aerial devices, which drop grenades with deadly precision. “Ninety per cent of our patients are from first-person view drones. We encounter few gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

Maj Oleksandr Holovashchenko at the underground installation for caring for injured soldiers in the eastern region.

During one day recently, three military members walked with difficulty into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a minor wound in his limb. “War is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Subsequently the Russians released a another grenade on him.” He added: “All structures in the settlement is destroyed. There are drones all around and casualties. Ours and theirs.”

The soldier said his squad endured over a month in a forest area near Pokrovsk, which enemy forces has been attempting to capture for many months. Sole access to get to their location was on foot. All supplies arrived by drone: rations and water. A week following he was hurt, he traveled five kilometers (roughly three miles), requiring three hours, to a point where an armoured vehicle was able to evacuate him. At the clinic, a medical staff assessed his vital signs. After treatment, a medical attendant provided him with fresh civilian clothes: a shirt and a pair of light-colored jeans.

Artem Dvorskiy, twenty-eight, said a first-person view drone ripped a small hole in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, said a drone blast had resulted in concussion. “My position was in a dugout. Suddenly it went dark. I lost sensation anything or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been killed. 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 the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the back. He groaned as medical staff laid him on a bed, removed a bloody bandage and treated his recent injury from fragments. Wrapped in a foil blanket, he used a cellphone to call his family member. “A fragment of mortar struck me. It was a deflected projectile. I’m OK,” he informed her. What were his plans now? “To get better. That will take a several months. Subsequently, to go back to my military group. Our forces has to protect our nation,” he said.

Doctors care for the wounded soldier, who was hit in the dorsal area by a piece of artillery shell.

Over the past years, enemy forces has repeatedly attacked medical centers, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 health workers have been killed in nearly 2,000 assaults. The underground facility is built from multiple reinforced shelters, with wooden supports, soil and sand laid on top reaching the surface. It is designed to resist direct hits from 152mm projectiles and even multiple 8kg explosive devices released by drone.

A major industrial group, which financed the construction, plans to build twenty facilities in all. A senior official of the nation's national security council and ex- military leader, Rustem Umerov, said they would be “critically essential for saving the lives of our military and supporting troops on the battlefront.” The company referred to the initiative as the “largest-scale and challenging” it had implemented after Russia’s invasion.

An example of the facility's operating theatres.

Holovashchenko, explained some injured personnel had to wait many hours or even days before they could be transported due to the threat of aerial attacks. “We had two severely injured patients who arrived at 3am. It was necessary to perform a removal of both limbs on one of them. His tourniquet had been applied for so long there was no alternative.” How did he cope with traumatic operations? “My career in healthcare for two decades. One must concentrate,” he remarked.

Orderlies wheeled the soldier up the tunnel and into an ambulance. The transport was parked under a bush. The patient and the two other soldiers were taken to the urban center of Dnipro for additional medical care. The underground hospital staff took a break. The facility's orange feline, the mascot, padded up to the doorway to await the next arrivals. “We are active 24 hours a day,” the surgeon said. “It doesn’t stop.”