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Scrubby foliage conceal the entryway. One sloping timber tunnel leads down to a well-illuminated reception area. Inside lies a surgery unit, equipped with beds, heart rate sensors and ventilators. And cabinets full of healthcare supplies, medications and neat piles of extra garments. Within a break area with a laundry appliance and hot water heater, doctors keep an eye on a screen. It shows the movements of enemy surveillance UAVs as they weave in the sky above.

Medical staff at an underground medical center observe a screen displaying enemy kamikaze and surveillance drones in the area.

This is Ukraine’s covert below-ground hospital. The facility began operations in August and is the second of its kind, situated in eastern Ukraine not far from the combat zone and the city of a key location in Donetsk oblast. “Our facility sits 6 metres under the ground. It’s the most secure method of delivering care to our injured military personnel. And it keeps healthcare workers safe,” said the facility's lead doctor, Major the chief surgeon.

This medical station handles 30-40 patients a each day. Cases differ widely. Some have catastrophic limb trauma necessitating amputations, or serious abdominal injuries. Some patients can walk. The vast majority are the casualties of Russian FPV drones, which drop explosives with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. It’s an age of drones and a different kind of war,” the surgeon explained.

Major Oleksandr Holovashchenko at the subterranean facility for caring for injured soldiers in eastern Ukraine.

During one day recently, three soldiers walked with difficulty into the hospital. The least severely hurt, 28-year-old one soldier, said an first-person view drone blast had torn a small hole in his leg. “Conflict is terrible. My comrade next to me, a fellow soldier, was fatally wounded,” he said. “He fell down. Subsequently the Russians dropped a second grenade on him.” He continued: “Everything in the village is demolished. We see drones everywhere and casualties. Our side's and the enemy's.”

Dvorskyi said his squad spent over a month in a wooded zone close to the city, which Russia has been attempting to capture for many months. The only way to reach their position was by walking. Necessary provisions came by quadcopter: rations and water. A week following he was hurt, he traveled five kilometers (about 3 miles), taking three hours, to where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his physical condition. After treatment, a nurse provided him with new civilian clothes: a shirt and a pair of pale denim trousers.

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

Another patient, 38-year-old Pavlo Filipchuk, said a UAV explosion had resulted in concussion. “I was in a dugout. Suddenly it went dark. I couldn’t feel any feeling or any sound,” he explained. “I believe I was lucky to remain alive. A relative has been lost. There are ongoing detonations.” A builder working in a neighboring country, Filipchuk noted he had returned to Ukraine and volunteered to serve days before the Russian leader's full-scale invasion in early 2022.

Another military member, a serviceman, had been hit in the upper body. He expressed pain as doctors placed him on a medical cot, took off a stained bandage and treated his recent injury from fragments. Wrapped in a thermal sheet, he borrowed a mobile phone to ring his sister. “A piece of mortar struck 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. After that, to go back to my unit. Someone must defend our nation,” he said.

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

Over the past years, enemy forces has repeatedly attacked hospitals, health facilities, obstetric units and emergency vehicles. Per human rights groups, 261 medical personnel have been killed in almost 2,000 assaults. This subterranean hospital is constructed from four reinforced shelters, with timber beams, soil and sand laid on top reaching the surface. It can withstand direct hits from large-caliber projectiles and even multiple eight-kilogram explosive devices dropped by aerial means.

The Ukrainian steel and mining company, which funded the building, intends to erect twenty units in all. The head of Ukraine’s national security council and ex- military leader, Rustem Umerov, said they would be “vitally important for preserving the lives of our military and supporting defenders on the battlefront.” The company described the project as the “most ambitious and challenging” it had undertaken since the enemy's military offensive.

An example of the facility's operating theatres.

The surgeon, said certain wounded soldiers had to wait hours or even days before they could be evacuated due to the danger of air assaults. “We had two severely injured casualties who arrived at the early hours. It was necessary to carry out a double amputation on a patient. His tourniquet had been on for so long there was no alternative.” How did he cope with traumatic operations? “I’ve been medicine for 20 years. You have to concentrate,” he said.

Orderlies transported Mykolaichuk up the passage and into an ambulance. The vehicle was stationed under a bush. He and the other military members were taken to the city of Dnipro for additional medical care. The underground hospital staff took a break. The hospital’s orange feline, Vasilevs, padded up to the doorway to greet the incoming patients. “We are open around the clock,” the surgeon stated. “It doesn’t stop.”