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Sparse trees conceal the entrance. A descending wooden tunnel leads down to a brightly lit welcome zone. There is a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. And cabinets full of medical equipment, drugs and organized stacks of spare clothes. In a staff room with a laundry appliance and hot water heater, doctors monitor a display. It shows the flight patterns of Russian spy drones as they zigzag in the sky above.

Medical staff at an underground medical center observe a monitor showing Russian kamikaze and reconnaissance drones in the region.

Welcome to the nation's secret below-ground medical facility. The facility opened in the eighth month and is the second such installation, located in the eastern part of the country not far from the combat zone and the city of a key location in Donetsk oblast. “Our facility sits six meters under the earth. This is the safest method of delivering care to our injured military personnel. It also ensures medical personnel safe,” said the facility's surgeon, Major the chief surgeon.

The stabilisation point handles 30-40 casualties a each day. Their conditions vary. Some have catastrophic limb trauma necessitating surgical removal, or serious stomach wounds. Some patients can move on their own. Almost all are the casualties of Russian FPV aerial devices, which drop grenades with lethal accuracy. “90% of our cases are from first-person view drones. We encounter minimal gunshot wounds. It’s an era of unmanned aircraft and a different kind of conflict,” the doctor explained.

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

During one afternoon recently, three military members walked with difficulty into the hospital. The most lightly injured, twenty-eight-year-old one soldier, said an FPV blast had torn a minor wound in his leg. “War is horrific. The guy beside me, a fellow soldier, was fatally wounded,” he said. “He collapsed. Then the enemy forces released a second grenade on him.” He added: “Everything in the settlement is demolished. We see drones all around and casualties. Ours and the enemy's.”

Dvorskyi said his unit spent over a month in a wooded zone close to Pokrovsk, which enemy forces has been attempting to capture for many months. The only way to get to their position was by walking. All supplies came by quadcopter: food and water. A week following he was injured, he traveled five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medical staff assessed his vital signs. Following care, a medical attendant gave him fresh civilian clothes: a shirt and a set of light-colored denim trousers.

The soldier, twenty-eight, said a FPV aerial device caused a minor injury in his leg.

Another patient, 38-year-old a serviceman, said a UAV explosion had left him with concussion. “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. A relative has been lost. There are ongoing detonations.” A construction worker employed in Lithuania, he noted he had returned to Ukraine and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

Another military member, Taras Mykolaichuk, had been struck in the back. He expressed pain as medical staff placed him on a bed, took off a bloody dressing and treated his recent shrapnel wound. Covered in a thermal sheet, he used a cellphone to call his sister. “A piece of artillery hit me. The cause was a ricochet. My condition is stable,” he told her. What comes next for him? “To get better. This may require a few months. Subsequently, to go back to my military group. Our forces must defend our country,” he said.

Medical staff treat Taras Mykolaichuk, who was hit in the back by a fragment of artillery shell.

Since 2022, Russia has repeatedly attacked hospitals, clinics, obstetric units and ambulances. Per international monitors, 261 health workers have been fatally attacked in nearly 2,000 assaults. This subterranean hospital is constructed from multiple steel bunkers, with timber beams, earth and sand laid on top reaching the surface. It is designed to resist impacts from large-caliber artillery shells and even multiple eight-kilogram TNT charges released by drone.

A major industrial group, which financed the construction, plans to build 20 facilities in total. A senior official of the nation's national security council and former military leader, the official, declared they would be “critically important for saving the lives of our military and supporting defenders on the frontline.” The company referred to the initiative as the “most ambitious and demanding” it had undertaken after the enemy's invasion.

An example of the centre’s operating theatres.

The surgeon, said some injured personnel had to endure delays hours or even multiple days before they could be transported due to the threat of air assaults. “Our facility received a pair of severely injured casualties who came at the early hours. It was necessary to perform a double amputation on one of them. His tourniquet had been on for so long there was no alternative.” What is his method with traumatic operations? “I’ve been medicine for two decades. One must focus,” he remarked.

Orderlies transported the soldier up the tunnel and into an emergency vehicle. The vehicle was stationed under a shrub. He and the two other soldiers were taken to the urban center of Dnipro for further treatment. The underground hospital staff took a break. The facility's orange feline, Vasilevs, walked up to the entrance to await the incoming patients. “Our facility operates active 24 hours a day,” the surgeon said. “It doesn’t stop.”