It was pouring rain in the Nepali village of Kaskikot, which was bad news for Laura Spero and the ceremony she had planned.

Mid-April was far too early for monsoon weather, but one thing the 33-year-old had learned since she began traveling regularly between Bethesda, Maryland, and Nepal 11 years ago was that nothing in Nepal happens on schedule.

Kaskikot is a village of roughly 12,000 on a mountainside beneath the Himalayan Annapurna range. Almost everyone is a member of a subsistence farming family; they eat what they grow, and daily life is difficult. Water must be hauled, buffalos milked and kitchen fires built so that when the power goes out — which it does daily — rice can still be cooked. People have little energy to trek 30 minutes to attend ceremonies at the local health post. Especially in the rain.