At least 34 people have died and dozens more are injured after air strikes from Myanmar's military hit a hospital in the country's west on Wednesday night, according to ground sources.

The hospital is located in Mrauk-U town in Rakhine state, an area controlled by the Arakan Army - one of the strongest ethnic armies fighting the country's military regime.

Thousands have died and millions have been displaced since the military seized power in a coup in 2021 and triggered a civil war.

In recent months, the military has intensified air strikes to take back territory from ethnic armies. It has also deployed paragliders to drop bombs on its enemies.

The Myanmar military has not commented on the strikes, which come as the country prepares to vote later this month in its first election since the coup.

However, pro-military accounts on Telegram claim the strikes this week were not aimed at civilians.

Khaing Thukha, a spokesperson for the Arakan Army, told the BBC that most of the casualties were patients at the hospital.

"This is the latest vicious attack by the terrorist military targeting civilian places," he said, adding that the military "must take responsibility" for bombing civilians.

The Arakan Army health department said the strike, which occurred at around 21:00 (14:30 GMT), killed 10 patients on the spot and injured many others.

Photos believed to be from the scene have been circulating on social media showing missing roofs across parts of the building complex, broken hospital beds and debris strewn across the ground.

The junta has been locked in a years-long bloody conflict with ethnic militias, at one point losing control of more than half the country.

But recent influx of technology and equipment from China and Russia seems to have helped it turn the tide. The junta has made significant gains through a campaign of airstrikes and heavy bombardment.

Earlier this year, more than 20 people were killed after an army motorised paraglider dropped two bombs on a crowd protesting at a religious festival.

Civil liberties have also shrunk dramatically under the junta. Tens of thousands of political dissidents have been arrested, rights groups estimate.

Myanmar's junta has called for a general election on 28 December, touting it as a pathway to political stability.

But critics say the election will be neither free nor fair, but will instead offer the junta a guise of legitimacy. Tom Andrews, the United Nations' human rights expert on Myanmar, has called it a "sham election".

In recent weeks the junta has arrested civilians accused of disrupting the vote, including one man who authorities said had sent out anti-election messages on Facebook.

The junta also said on Monday that it was looking for 10 activists involved in an anti-election protest.

Ethnic armies and other opposition groups have pledged to boycott the polls.

At least one election candidate in in central Myanmar's Magway Region was detained by an anti-junta group, the Associated Press reported.