At least 17 people have been killed in southeast Peru as protests seeking immediate elections resumed in neglected rural areas of the country still loyal to overthrown President Pedro Castillo.

The clashes occurred in Juliaca near the banks of Lake Titicaca in the Puno region, and left 68 people injured, Henry Rebaza, a Puno health ministry official, told the state-run television channel TV Peru on Monday.

Some of the bodies had bullet wounds, Puno’s regional health director, Ismael Cornejo, told local radio station RPP.

It was the highest death toll since the unrest began in early December when Castillo was removed and arrested following a widely condemned attempt to dissolve Congress and head off his own impeachment.

The office of Peru’s ombudsman has called for police to comply with international standards in using force and for investigations into the deaths while urging protesters to refrain from attacking property or impeding the movement of ambulances.

Castillo’s successor, his former running mate Dina Boluarte, has supported a plan to push up to 2024 presidential and congressional elections originally scheduled for 2026.

She has also expressed support for judicial investigations into whether security forces acted with excessive force against protesters.

But such moves have so far failed to quell the unrest, which after a short respite around the Christmas and New Year’s holidays have resumed with force in some of Peru’s poorest areas, where support for Castillo’s unorthodox rule had been strongest.

With Monday’s casualties, the number of people killed in clashes with security forces climbed to 39. Hundreds more have been treated for injuries.