This monk in a small cave, complete with diamond sceptre (the brass object in his hand at chest level) and bell was chanting a mantra near the Mebar Tsho (Burning Lake), which is one of the holiest sites in this part of Bhutan.
For those of us used to larger lakes, we would describe this "lake" as a slight widening in a very small river. Regardless, there were many Buddhist visitors at the site while we made a short stop there.
http://www.tourism.gov.bt/discover/the-burning-lake
We were told that the small cone-shaped objects were made of clay that was made with some of the ashes of the dearly departed. These were places near a number of the holy sites that we visited in Bhutan.