Circumcision, although relatively simple, does carry operational risks and can be extremely painful for the patient; many contend that it is totally unnecessary for health reasons and that, because it is most frequently performed on children, the suffering involved is inflicted without the patient's consent. The operation consists of cutting off the prepuce of the penis. (While there are instances of similar operations performed on females, such as cutting of the internal labia, the term circumcision is usually limited to males.) It is often a religious rite, notably among Jews and Moslems; some theologians argue, however, that there is no doctrinal reason for it. In developed countries, it is practised mainly for reasons of hygiene and cleanliness. Depending on the conditions accompanying the operation, complications can include infections, gangrene, wound diphtheria, septicaemia, and loss of the penis. There is also a possibility of haemorrhage, which can be fatal. If the patient is a newborn, there may be a deficiency of Vitamin K.
Five youths in bush schools in the Northern Transvaal died during one month in 1994 as a result of ritual circumcision.