The top U.S. health official trudged through a Vietnamese market Saturday where live chickens are sold and slaughtered in an effort to get a very firsthand look at the difficulties of controlling bird flu. U.S. Health and Human Services Secretary Mike Leavitt was on the Vietnam leg of a Southeast Asian tour, a week after officials from 80 countries met in Washington to discuss how to prevent and contain a potential global health threat. He will also be adding a stop in Indonesia. After watching chickens and ducks being gutted and cleaned on the sidewalk, Leavitt said it will be difficult to change behavior that is a regular part of people's lives. "It's evident to me that part of the dilemma here is the cultural momentum because it's happened for hundreds of years and the chances of changing it anytime soon are very low," he said while walking through the open-air market. "It adds obviously to the equation and to the possibility that you will see an outbreak at some point." During Leavitt's trip, which also included stops in Thailand, Cambodia and Laos, he has repeatedly warned of a potential flu pandemic and the importance of all countries rallying together to quickly come up with preparedness plans as the deadly H5N1 bird flu virus is detected in countries closer to Europe. The disease has hit Vietnam harder than any other country, killing 43 people and 45 million birds, and decimating the flocks of poor farmers.