The mystery of MH370 & Malaysia’s hapless response

Graphics Generated by AHeneen

Flight MH370 was a Boeing 777-200ER on a scheduled flight operating between Malaysian capital Kuala Lumpur and Beijing in China that disappeared on the 8th March 2014 with 239 people on board – 227 passengers and 12 crew.

In command was 53-year-old Captain Zaharie Ahmad Shah from Penang – who’d been flying since 1981 when he joined Malaysia Airlines as a cadet. By 1983 he became a second officer He was promoted to captain of Boeing 737-400 airliners in 1991, captain of Airbus A330-300 in 1996, and captain of Boeing 777-200 in 1998. His total experience was 18 365 hours.

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The co-pilot was 27-year-old First Officer Fariq Abdul Hamid who joined Malaysia Airlines as a cadet pilot in 2007, then became a second officer of Boeing 737-400 airliners two years later. After flying as First Officer on Boeing 737-400s and Airbus A330’s in 2012, he trained to be a first officer on board Boeing 777-200 aircraft.

He was far less experienced with 2 763 hours total flying time.

Because of Malaysia’s notorious cockpit resource management issues, the co-pilot would have deferred constantly to the Captain, unlike where I fly for example where you fail tests if you don’t question the Captain’s faulty decision-making.

And Flight 370 was Fariq Abdul Hamid’s finally training flight – the next he was supposed to take was an exam so that means he would have been even more sensitive to commands than usual.

It’s the captain Zaharie Ahmad Shah who has been scrutinised the most closely since the crash. There are salacious stories about his philandering and the fact that his wife was about to leave him taking their two children.

The pilots last made voice contact with air traffic control at 01:19 Malaysian Standard time when it was over the South China Sea, less than an hour after take-off. This was precisely at a reporting point. How convenient.

It disappeared from air traffic controllers’ radar screens three minutes later as it appeared both ACARS and the Transponder were switched off, but was being tracked by military radar as it suddenly dived in a south westerly direction.

It turned steeply to the left or north, then turned again to the South West in a manoeuvre which takes some skill or the plane either stalls at that height, or goes into a spiral dive.

At the time that the transponder and ACARS stopped functioning,  the military radar followed the plane until 01.35 – eight minutes after the turn, when it was flying at 35,700 ft on a 231° magnetic heading, with a ground speed of 496 knots.

The military radar track shows that the plane then flew back over northern Malaysia its altitude fluctuated between 31000 and 33000 feet.

The Boeing 777-200ER then turned steeply to the north west and flew over the Andaman sea between Malaysia and Indonesia where the last primary radar signal was picked up at 02 hundred hours 22 heading towards the Nicobar Islands,  200 kilometres north of Bandah Aceh province of Indonesia.

AT that stage it was flying at 29 500 feet and around 490 knots, apparently it appeared to be flown by hand as the altitude was changed by more than 4000 feet over a few minutes. Or the autopilot had been coded incorrectly and was jumping about which is highly unlikely.

Why did the pilots switch off the transponder and ACARS simultaneously or within seconds at the precise point that they were required to change frequency  and report to Vietnamese Air Traffic?

Cockpit of 9M-MRO by Chris Finney

This is such a coincidence that even though lacking correlation with other data, you have to ask – who was so well briefed that they knew to switch off the tracking information at the point of handover?  How could someone in the back of the plane know this unless they were carrying GPS devices – and then make their way into the flight deck, break the door down, overpower those inside, all after the captain who’s voice has been positively identified, had just announced the flight was at a reporting point?

Think about this logically – its almost impossible that seconds later, the transponder was switched off along with ACARS?

It had to have been one of the pilots who cut the communication I’m afraid.

Whomever did this could have bought themselves a few minutes before Vietnam ATC realised MH370 who had been handed over to them, was not attempting to make contact.

At 01:38 MYT, Ho Chi Minh Area Control Centre contacted Kuala Lumpur Area Control Centre to query the whereabouts of Flight 370 and informed them that they had not established verbal communication with Flight 370, which was last detected by radar at waypoint BITOD. That’s over the South China Sea between the two countries.

They continued phoning each other for another 20 minutes as the mystery deepened.

At first Malaysia thought the plane was over Cambodian air space, to the west of Vietnam.

The Boeing had actually turned the opposite direction and at times flew over the southern border of Thailand where it meets Malaysia’s northern territories.

We do have a tiny bit of data about what happened next. The planes’ Rolls Royce engines were pinging the INMARSAT satellite every hour with information. The problem is, this only provides a single point of data not four like GPS, so investigators could only see where it was on a line of latitude, but not whether it was north or south of anywhere.

The secondary ACARS is a measure of the transmission time to and from the airplane measuring the plane’s distance from the satellite. Because it’s a single bit of data, it can’t pinpoint a single location but rather all equidistant locations—a roughly circular set of possibilities.

Think trigonometry.

Given the range limits of MH370, the near-circles can be reduced to arcs across the world but only read hourly.

The most important arc was the seventh and last one or last hour —defined by a final handshake tied in complex ways to fuel exhaustion and the failure of the main engines.

The seventh arc stretches from Central Asia in the north to the Antarctica in the south.

It was crossed by MH370 at 8:19 a.m., Kuala Lumpur time. Calculations of likely flight paths place the airplane’s intersection with the seventh arc—and therefore its end point—in Kazakhstan if the airplane turned north, or in the southern Indian Ocean if it turned south.

It was agreed that Kazakhstan was unlikely because the Boeing would have flown through quite a bit of military radar space.

So it was decided, correctly as we now know, that MH370 followed the southern Arc.

But that’s a vast area.

Why did the transponder and ACARS disappear from air traffic control radar at the same time? Transponders send information about planes altitude, direction and speed constantly and are provided this data by the flight computer.

So how do you switch a transponder off in a Boeing 777-200ER? 

Simple, you flick a switch. ACARS is a completely different baby as I’ll explain.

Transponders are accessible for a number of reasons. On the ground, they tend to cause radio interference with so many planes on apron, taxying, taking off, landing.

When pilots are cleared onto the runway to take off, part of the drill is to turn on the Transponder and in propeller driven planes, to check the fuel boost pump is on and the strobe light is turned on.

We have a little mantra called LIGHTS CAMERA ACTION – which my instructor hated by the way. Lights are the strobe, camera is the transponder, and action is the fuel boost pump.

At the same time, ATC picks up the transponder number which is a four digit number – usually when flying in the circuit its 2000 but could be any four digit number and is provided by ATC or Radar information facilities.  It’s called squawking a number – imagine a duck sending out a squawk letting other ducks know who and what it is.

Except for the three recognized emergency transponder signals. Squawking 7700 tells radar that you have an emergency of some kind, 7600 means you’ve lost comms, and 7500 means the plane has been hijacked.

In MH370 the transponder was off, no-one squawked any of the emergency codes.

It turned into the most expensive  search operation in aviation historyand was suspended after yielding no evidence of the aircraft other than some marine debris on the coast of Africa and islands.  It cost $155 million with Malaysia coughing up 58% of the total cost, Australia 32%, and China 10%.

The report also concluded that the location where the aircraft went down had been narrowed to an area of 25,000 km2 by using satellite images and debris drift analysis.

But over the past six years, debris definitely linked to MH370 has washed up – and eventually at least 20 pieces were positively Id’d as coming from the plane registration 9M-MRO.

In-air break-ups of Commercial Airliners

The Wright Flyer. Source: Library of Congress

In episode 10 of Plane Crash diaries we investigated in-air breakups of aeroplanes – caused by poor flying, poor design, or poor maintenance and bad weather. In some cases all four of these together.

However as with all things aviation, every accident leads to an equal and opposite reaction .. to misquote the great Sir Isaac Newton.

That reaction luckily for us, is called Aviation safety standards. The terrible truth is that people die and then safety improves.

So let’s start with the 32 year-old Charles Rolls. He was one half of the great Rolls-Royce engine company but his end was rather unfortunate.

He was killed when the tail of his Wright Flyer aircraft fell off in 1910 in Bournemouth and thus was unceremoniously ushered into aviation history as the first to die in a British air accident. And he was one of the first Englishman to die in what became known as in-air break up. The Wright Flyer was a copy of the original Wright Brothers plane that flew at Kittyhawk in 1903.

That didn’t stop Rolls-Royce from turning into developing the world’s top turbine engines but it put paid to the Wright Flyer which was largely out of date anyway by then and Rolls’ demise proved it was not really built to last.

Probably the most famous of all in-air break ups involved the notorious de Havilland Comet. It took three catastrophic failures all within a year before the airliner was grounded.

Launched by BOAC in 1952, the Comet was the world’s first jet airliner and was an attractive plane too. Aviation buffs swooned over its swept back look, the modern jet liner was born and it could fly right across the Atlantic without a stop.

However, it had a serious flaw. The windows and doors.

At that time the way in which aircraft fuselage expanded and contracted due to the huge pressure differences was not well known and the engineers built a defect into the Comet.

They had rectangular windows. We now know all plane windows are rounded in shape, and that’s for a reason and you can thank the Comet for the safer windows we enjoy on board our commercial flights.  

In 1953 and 1954, three Comets broke up soon after take-off killing everyone on board. Two of these break-ups took place over the Mediterranean while the plane was climbing to its cruising altitude and a third crashed in a thunder storm on a flight from Calcutta to Delhi in India.

In January and April 1953 the two that crashed in the Med took off from the same airport – Rome’s Ciampino. At first there were thoughts about sabotage, perhaps explosives.

De Havilland Comet. Beautiful but lethal. Source: Wikipedia.

However after the Comet crashed in India, the plane was grounded. An extensive programme that followed has since been copied in many plane crash investigations. The probe was led by Sir Arnold Hall who was director of the Royal Aircraft Establishment at Farnborough. Engineers rebuilt the recovered wrecks on the ground, and then subjected the hull of a new jet to pressurisation tests in a massive water tank.

Rebuilding wrecks on the ground is now standard practice.

Eventually, Sir Arnie and his team of boffins discovered what had been going wrong. Cracks developed in the fuselage around the doors and window apertures as the plane was subjected to pressure changes mimicking take offs and landings.

The rivets around the doors and windows could not take the stretching forces and all three plane’s had literally blown apart at the seams in mid-air. Doors that were rounded were fitted – similar to what we now see on all aircraft, while the windows were also changed.

The Comet was redesigned and then renamed the Nimrod which continued flying more than sixty years after the maiden Comet flight in 1949.  Used mainly by the military, the Nimrod continued in various forms until 2011 deployed as an advanced and dedicated airborne early warning platform and maritime patrol aeroplane.

Across the Atlantic, aviation engineers in the United States were watching the terrible Comet crashes with a great deal of interest.

Britain may have launched the first commercial jet, but America was going to make air travel its own.  Boeing and Douglas were the two manufactures to benefit from the new safety rule of building with round doors and windows.

Engineers in the United States  took note of the new designs and were able to incorporate these into the hugely successful jetliners made by Boeing and Douglas that were to dominate not just transatlantic but global long-distance services.

As some have said, it was the passengers of the three Comets who paid for Boeing and Douglas’ research – with their lives.

We will leap forward to the 80s for our next example.

One of the most incredible in-air failures ended with almost everyone surviving. In April 1988, part of the fuselage of an Aloha 737 flying from Hilo to Honolulu shredded at 24,000ft.

Route of Aloha Airlines flight 243 which was flying from Hilo to Honolulu. Source: NASA.

A flight attendant was swept overboard – everyone else survived.  Imagine sitting in the open air with nothing between them and the ocean except for a safety belt.

The Boeing 737 had reportedly experienced more than 89 000 re-pressurisation changes.

This led directly to the Federal Aviation Authority setting up the National Aging Aircraft Research Programme. Testing defects in design, the effect of corrosion, resonances in different metals and so on, the Aircraft Structural Test Evaluation and Research facility was launched.

Predicting where and after how long structures would fail due normally to repetition, helped increase safety in aviation.

That may be so, but it took a 1991 accident to kick start a proper global culture of aviation safety.

The mid-air break up of the Continental Express Flight 2574 – an Embraer 120 Brasilia, was a scheduled domestic passenger airline flight operated by Britt Airways from Laredo International Airport in Laredo, Texas, to Houston Intercontinental Airport  or IAH in Houston, Texas.

With terrible timing for later events, on September 11, 1991, the Embraer, crashed, killing all 14 people on board. The aircraft wreckage hit an area near Eagle Lake, Texas which is located approximately 65 miles west-southwest of its destination of Houston.  

Flight 2574 wreckage map. Source: NTSB report.

Initial reports suggested a bomb was the cause of the plane coming apart, but the National Transportation Safety Board found the real cause were missing screws on the horizontal stabilizer.

It’s always horrible to consider that the crew consisting of Captain 29-year-old Brad Partridge and first officer 43-year-old Clint Rodosovich together with 33-year old flight attendant, Nancy Reed did nothing wrong.

Both Partridge and Rodosovich were experienced pilots with 4,243 flight hours and 11,543 flight hours (including 2,468 hours and 1,066 hours on the EMB 120 Brasilia).

The EMB 120 took off at just before ten past nine in the morning of  the 11 September and were cleared to cruise at 25 000 feet.

At a few minutes to ten after reaching the cruising altitude, Houston Air Route Traffic Control Centre reassigned 24 000 feet. Then as it continued descending for Houston Intercontinental Airport descending through 11 500 feet at around 260 knots, the leading edge of the left horizontal stabilizer separated from the airframe.

The plane pitched down dramatically, rolling around its axis and the left wing folded like cardboard. The fuel escaped and ignited. Mercifully it is believed all passengers and the pilots lost consciousness in the massive G-forces that were produced in the spin.

The crippled craft fell in southeast Texas exploding on impact. The wreckage was spread over almost four square miles – some even making it to the Colorado River many miles away.

IT was the maintenance crew who were blamed. The previous evening they were working on the stabilisers but there had been a shift change and the screws that were removed from the horizontal stabilizer had not been replaced.

This led to major changes in safety inspections before during and after maintenance.

The FAA conducted a National Aviation Safety Inspection Program (or NASIP) of Continental Express’ maintenance program. Because the failure to inspect the parts after the shift changeover was recorded, NASIP processes were then regarded as deficient.

The big change linked to the in-air break up of this plane was the dramatic turning point in Safety Culture in the United States. That had a knock on effect worldwide.

Safety culture became the watchword, then in April 2000 the Wendell H. Ford Aviation Investment and Reform Act for the 21st Century, or AIR 21 was launched.

The most important part of the bill was the inclusion of the “Aircraft Safety Act of 1999,” which proposed to help stop the practice of manufacturing, distributing, and installing fraudulent aircraft parts. I’ll feature this terrible scourge in a future podcast too – how grey parts have caused many accidents.

A break-up of a plane over Peru deserves special mention at this point. As you’ll hear in this series, there are many examples of a single person surviving a plane crash. And this is one of them.

Today we hear about the extraordinary story of Juliane Koepcke. She was 17 years old and sitting in the window seat next to her mother on board a Lansa Aircraft flight 508 from Lima in Peru to Pucallpa in the middle of the Amazon Rain Forest.  

The final destination was a town further on called Iquitos.

It was Christmas eve 1971 and Juliane had just written an exam. More about that in a moment.

Lansa Flight 508 was a Lockheed L-188A Electra turboprop, registered OB-R-941, operated by Lineas Aéreas Nacionales Sociedad Anonima  or LANSA for short.

The plane took off from Lima then  flew into a thunderstorm just over the Andes. The storm was accompanied by turbulence. It’s thought that a bolt of lightning then struck one of the fuel tanks and it exploded, tearing off the right wing.

The Lockheed went into a spin and disintegrated.

All 91 of the 92 passengers and crew were killed, except for one – Juliane Koepcke.

Juliane Koepcke in 2019. Source: Munich University.

The German teenager was thrown out of the plane still strapped to her seat. As film maker Werner Herzog said, she didn’t leave the plane, the plane left her.

Juliane later re-countered how she remembered falling head first with the seatbelt digging into her stomach and a canopy of trees spiralling towards her.

Then she lost consciousness but woke up the next morning on the floor of the rainforest.

She had dropped two miles through the air and had a broken collarbone, a gash on her leg, a small cut on her arm and a mild concussion. But she could walk.

Juliane had a much bigger problem. She was stuck in the middle of the rainforest with only a small bag of sweets. Worse, her glasses had been lost and she couldn’t tell the difference between a leaf and a wriggling snake.

But she knew quite a bit about jungles – even as a 17 year-old. You see She was the only child of biologist Hans-Wilhelm Koepcke and ornithologist Maria Koepcke. When Juliane was fourteen, her parents left Lima to establish a research station in the Amazon rainforest.

She became a “jungle child” and learned survival techniques. But German educational authorities disapproved and ordered the family to send her back to Deutsche Schule Lima Alexander von Humboldt to take her examinations which she did a few days before the crash.

IT was because of their demand she write exams in Lima that the child of the jungle ended up falling into the jungle.

Of course she was surrounded by a long list of animals, plants and insects that were deadly. Somehow she survived for ten days and was eventually  found by forest workers on January 3rd 1972. She had no boots, no machete, no glasses.

Really an incredible story.

Koepcke became an international sensation. The young German then decided it was all too much and took a decision to disappear by 1973.

Eventually she remerged in 2011 when her memoir of the crash called When I Fell from the Sky,  was published. Juliane is still alive and is a mammologist who specialises in Bats and lives – I hope – a quiet life as librarian at the Bavarian State collection of Zoology in Munich.

While the lightning strike which is still known as the deadliest in aviation history, it’s also an example of poor decisions by the air crew. Instead of diverting because of thunder storms the LANSA captain decided to continue because of pressure to meet the holiday schedule.

Get there-it is its called in aviation. Get there even when its wiser to wait.

Peruvian investigators cited “Intentional flight into hazardous weather conditions” as a cause of the crash.

There’s another I have to mention and it involved something known as Clean Air Turbulence which led to an in-air breakup of a commercial airliner.  

In the case of BOAC flight 911 callsign Speedbird 911, clean air turbulence produced

an estimated 7.5Gs that caused the Boeing to disintegrate over Mount Fuji in Japan on 5th March 1966. 

Clean Air turbulence will be covered in a future podcast, but needless to say there’s no warning.

All 113 passengers and 11 crew perished.

The Boeing was still climbing out of Tokyo and had reached 16 000 feet when it hit the massive clear air turbulence flying at 370 knots.

Analysis of wreckage allowed the accident investigators to determine that the vertical stabiliser attachment to the fuselage failed first. Then the port side horizontal stabiliser failed as the plane spun to the left.

BOAC Flight 911 intended route. It crashed shortly after take-off. Source: ASN Aircraft Accident Database.

A short time later, the ventral fin and all four engine pylons failed followed by the remainder of the empennage.  

The aircraft then entered a flat spin, with the forward fuselage section and the outer starboard wing breaking off shortly before impact with the ground.

An 8 mm film exposed by one of the passengers was recovered from the wreckage. It showed pictures of the Tanzawa Mountains and Lake Yamanaka, followed by two empty frames and then apparently images of the aircraft’s interior, before ending abruptly.

Tests suggested that the two empty frames may have been the result of structural loads of up to 7.5 g momentarily jamming the camera’s feeding mechanism.

Investigators did find stress cracks in parts of the tail assembly. But even without the cracks, the plane would have broken apart. What really put paid to the Boeing was the wind and Mount Fuji.  High winds flowing over the 12 388 foot peak meant tricky air currents in the vicinity.

I’ve hit winds over mountains – in one case was flying past the Magaliesburg mountains in South Africa’s Gauteng province. I was cruising at 140 knots on the leeward side – more than 5 nautical miles away and two thousand feet above the peaks. Suddenly  the plane rolled viciously 60 degrees to the right – hit by turbulence. I’d hit clean air turbulence courtesy of the mountains.

That was what is known as mountain waves and all pilots are wary of strong winds and flying in the vicinity of mountains, particularly down-wind where currents eddy and whirl like powerful ocean waves around rocks.

The BOAC flight had other strange facts. IT took off less than 24 hours after Canadian Pacific Airlines Flight 402 crashed and burned on landing at Tokyo’s Haneda airport. In fact in a chilling moment, passengers on BOAC speedbird flight 911 had looked out on the still smouldering wreckage of Flight 402 immediately before taking off for the last time.

The victims included a group of 75 Americans working for the Thermo King company of Minneapolis, Minnesota, on a two-week company sponsored tour of Japan and Southeast Asia.

There were 26 couples travelling together in the group, and 63 children were orphaned as a result of the accident.

In a macabre coincidence, five passengers cancelled their tickets at the last moment to see a ninja demonstration – they were researching a movie. The five were in Japan scouting locations for the fifth James Bond film called  You Only Live Twice.

Yes, truth is stranger than fiction.

With that slightly ominous fact ringing in our ears, it’s time to end. Please check out the blog Plane Crash Diaries which I’m sprucing up at the moment. You can send me messages through the site.

Next episode will cover fires in flight – and one of the examples will include South African Airways Flight 295 – a Boeing 747 that some say was carrying questionable cargo which caught fire leading to separation of the tail section and an in-flight break up.

Once again changes were made – IATA moved to end the practice of flying passengers on board aircraft that would also carry cargo. The so-called Boeing Combi type.

So until then, aviate, navigate and communicate safely.

The MAX 8 catastrophe for Boeing: A thirst for profit undermined a culture of safety

PK-LQP, Lion Air’s MAX 8 involved in the 2018 accident – photographed in September 2018 ©Wikipedia

Welcome back to Plane Crash Diaries with me your host Desmond Latham.

This week it’s the terrible crashes involving the Boeing 737 MAX 8 – one in October 2018 and the other in March 2019 which appears to have been caused by two main things.

On is an automated trim called the Movement Characteristics Augmentation System and the other is the shocking failure by one of the world’s most well known manufacturers – compounded by a cosy relationship between the Federal Aviation Authority and the world’s biggest aircraft manufacturer.

While the accident reports are awaited, there is enough information from both FAA and Boeing itself to cover this as an example of poor design, poor safety management, and poor oversight  – particularly when it comes to risk analysis.

Since the accidents Boeing has announced a slew of changes to its quality control process, including the announcement in September that a new Safety Committee was being created led by Boeing veteran Beth Pasztor. Too little too late for 349 people.

Boeing has built a name around allowing pilots to fly their planes, whereas Airbus had designed their planes around more automation, but back in the mid 2000s something really radical happened at the American plane manufacturer.

Somewhere in the engineering process, someone decided it would be a good idea to let the plane have the last say when it came to control – and imbedded the Manouvreing Characteristics Augmentation Software into the system. This was to prove catastrophic for 349 people – two entire plane loads of passengers and crew were killed because of this MCAS design fault.

The two accidents I’m covering this week are still fresh in the minds and therefore we must proceed with extra caution. Anyone who follows aviation closely and is objective will find the actions of some involved tantamount to criminal negligence.

So starting this tale with the Lion Air of Indonesia crash in October 2018.

Let’s begin by pointing out that Indonesia has an abysmal aviation safety record – probably one of the worst records in recent memory.

All of Indonesia’s airlines were blacklisted by European Union air-safety regulators and banned from entering EU airspace in 2007 because of concern over lack of regulatory oversight in Indonesia.

Lion Air was allowed back into the EU zone after a safety audit in 2016.

A database compiled by aviation analytics firm FlightGlobal shows that before the JT610 disaster, Lion suffered 11 major accidents since 2002: the total loss of five aircraft, five accidents that resulted in major damage, and one minor loss.

These accidents were caused by a host of reasons, but included poor maintenance and poor flying with pilots making basic errors on flap selection for example, as well as complete failure of situational awareness. So it would be easy to write off the first MAX 8 crash as another example of ramshackle Indonesian aviation culture.

But the Boeing Max 8 crash was different.

Lion Air Flight 610 was a scheduled domestic flight from Soekarno–Hatta International Airport in Jakarta to Depati Amir Airport in Pangkal Pinang only 440 kilometres away.

The Boeing 737 Max took off on 29 October 2018, carrying 189 passengers and crew.  The flight’s cockpit crew were 31 year-old captain Bhavye Suneja, who had flown with the airline for more than seven years and had over 6,000 hours of flight experience including 5,176 hours on the Boeing 737); and Indonesian co-pilot Harvino, who had 5,174 hours of flight experience, 4,286 of them on the Boeing 737.

The six flight attendants were also Indonesian.

The captain was at the controls of Lion Air flight JT610 when the jet took off from Jakarta, and the first officer was handling the radio.

While the cockpit voice recording has never been released, sources quoted by Indonesian and other media confirm the following took place.

Two minutes into the flight, the first officer reported a “flight control problem” to air traffic control and said the pilots intended to maintain an altitude of 5,000 feet, the November report said.

The first officer did not specify the problem, but according to at least one source airspeed was mentioned on the cockpit voice recording, and a second source said an indicator showed a problem on the captain’s display but not the first officer’s.

The captain asked the first officer to check the quick reference handbook, which contains checklists for abnormal events.

For the next nine minutes, the Boeing continued to sound alarms about stalling, and the MCAS pushed the nose downwards.

The captain fought to climb, but the computer, still incorrectly sensing a stall, continued to push the nose down using the plane’s trim system. Normally, trim adjusts an aircraft’s control surfaces to ensure it flies straight and level.

It appears to all that the crew did not know MCAS was causing the problem. You don’t have to be a rocket scientist to understand that a lack of training in this failure compounded what is now known to be an example of bad technical design.

According to sources quoted by Indonesian media, the crew thought only about airspeed and altitude – because that was the only thing they talked about.

Near the end, the captain asked the first officer to fly while he checked the manual for a solution.

About one minute before the plane disappeared from radar, the captain asked air traffic control to clear other traffic below 3,000 feet and requested an altitude of “five thou”, or 5,000 feet, which was approved.

As the 31-year-old captain tried in vain to find the right procedure in the handbook, the 41-year-old first officer was unable to control the plane.

The flight data recorder shows the final control column inputs from the first officer were weaker than the ones made earlier by the captain.

The Indian-born captain was silent at the end, all three sources said, while the Indonesian first officer said “Allahu Akbar”, or “God is greatest”.

The plane then hit the ocean at high speed, killing all 189 people on board.

The accident site was located 34 kilometres or 18 nautical miles off the coast of the island of Java. Investigators examining the Indonesian crash are considering how a computer ordered the plane to dive in response to data from a faulty sensor and whether the pilots had enough training to respond appropriately to the emergency, among other factors.

On 28 November, the Indonesian National Transportation Safety Committee (NTSC) released its preliminary accident investigation report.

After airspeed and altitude problems, an AoA sensor was replaced and tested two days before the accident.

It confirmed reports the day before where pilots had experienced the same conditions with the MCAS pushing the nose down in the same plane.

The air crew on that flight had switched off the electrical engine which drove the trimming and continued with manual trim.

The runaway stabilizer non-normal checklist was run, the electric stabilizer trim was turned off, and the flight continued with manual trim; the issues were reported after landing.

But the crew on 29th October didn’t follow the same procedure.

Shortly after takeoff on 29 October, issues involving altitude and airspeed continued due to erroneous AoA data and commanded automatic nose-down trim via the Maneuvering Characteristics Augmentation System (MCAS).

The flight crew repeatedly commanded nose-up trim over the final ten minutes of the flight.

Boeing issued a statement shortly afterwards pointing to the successful troubleshooting conducted on 28 October as evidence that the MCAS did not change runaway stabilizer procedures, and emphasised the longstanding existence of procedures to cancel MCAS nose-down commands.

What Boeing failed to mention was that it had also removed a crucial Angle of Attack sensor failure alarm which had existed in a previous version of the Boeing 737. They have not explained why this was done but its clearly to reduce costs for operators. Airlines could buy an upgrade that involved a sensor failure alarm.

This is going to haunt the company in future litigation.

Investigators who analyzed the flight data recorder after the October 29 crash uncovered a fault between two Angle of Attack Sensors located on the nose of the plane.  

It was the first major accident involving the new Boeing 737 MAX series aircraft, introduced in 2017, and the deadliest involving a 737, surpassing Air India Express Flight 812 in 2010.

It is the deadliest accident in Lion Air’s 18-year history – even for an airline dogged by incidents and accidents.

The first victim was identified two days after the crash then the flight data recorder was located on 1 November and recovered for analysis. The Cockpit voice recorder was eventually located in Mid January 2019.

Preliminary investigations revealed serious flight control problems that traumatized passengers and crew on the aircraft’s previous flight the day before the accident, as well as signs of Angle of attack (AoA) sensor and other instrument failures on that and previous flights, tied to a potential design flaw involving the Maneuvering Characteristics Augmentation System (MCAS) of the 737 MAX series.

As a result, the United States Federal Aviation Administration and Boeing issued warnings and training advisories to all operators of the 737 MAX series to avoid letting the MCAS cause an abrupt dive similar to the Lion Air flight.

But neither the FAA nor Boeing thought it apt that the MAX8 be grounded.

Jaw dropping – at the time as I reported on this crash it was pretty clear from initial reports by all involved in the previous flight that the MCAS system was causing a disturbingly dangerous situation.

Shortly after the Lion Air Crash in November  2018  The Wall Street Journal reported that Boeing and the FAA were planning to publish warnings about erroneous angle of attack indications on cockpit instrument displays of the 737 MAX in response to the Lion Air accident.

The Federal Aviation Administration then issued an emergency Airworthiness Directive (AD) requiring that amended operating limitations and procedures relating to erroneous data from an AoA sensor be inserted into the aircraft flight manual of each 737 MAX aircraft, and urged all airlines operating Boeing 737 MAX 8s to heed the warnings.

But they still did not advise an urgent training intervention. But some pilots I followed at the time were already calling the plane to be grounded.

During difference training, pilots of American Airlines and Southwest Airlines converting from earlier Boeing 737 Next Generation models to the 737 MAX were not informed of the MCAS linked to the fatal crash, leaving them concerned that they were possibly untrained with respect to other differences.

In November 2018, Aviation Week reviewed the 737 MAX flight crew operations manual and found that it did not mention the MCAS.

American Airlines’ Allied Pilots Association and Southwest Airlines Pilots’ Association were also caught unaware. The Wall Street Journal reported that Boeing had “decided against disclosing more details to cockpit crews due to concerns about inundating average pilots with too much information”.

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This is truly gobsmacking. All we do as pilots is deal with information – you tell us what is likely to go wrong and then we practice for these eventualities. What you don’t do is keep it a kind of secret because we’re .. in Boeing’s words .. average.

On 15 November, the US Air Line Pilots Association representing 61,000 pilots, urged the FAA and NTSB to ensure pilots receive all relevant information addressing a “potential, significant aviation system safety deficiency”.

This was still before the Ethiopian crash. No-one took much notice.  

But the United Airlines branch of the Airline pilots association said the MAX 8 should keep flying – despite reservations from more conservative pilots I was following at the time. They alleged the MCAS implication was mere speculation. They did this because they flew many MAX 8 planes and to ground them would have .. yes.. a big financial impact.

I wonder what they think now, this union. They put their own members in mortal danger by ignoring clear signs of technical failure merely because of business interests.

Tsk Tsk.

In an internal message on 19 November, Boeing CEO Dennis Muilenburg defended the Flight Crew Operations Manual as describing the MCAS relevant function.

But Boeing was taking heat -Lion Air co-founder and former CEO Rusdi Kirana  reportedly considered cancelling Lion Air’s outstanding 190 Boeing aircraft orders worth some $22 billion at list prices over what he viewed as an attempt by Boeing to blame Lion Air for the crash.

On 31 December, the family of the first officer filed a lawsuit against Boeing, claiming negligence. The lawsuit also claimed that the aircraft’s sensors provided inaccurate flight data, causing its anti-stall system to improperly engage, as well as Boeing not providing proper instructions to pilots about how to handle the situation

In March 2019, victims’ families reported irregularities, saying that Lion Air pressured them into signing away their rights to seek legal recourse for under-compensation.

But Boeing’s horror year was about to get worse, as the March 10 2019 crash of the Ethiopian Airlines Max 8, Registration ET-AVJ was blamed on the same MCAS-linked errors.

The other really horrible reality for passengers and crew on the next MAX 8 crash in Ethiopia was these advisories were not fully implemented. And they also pointed to a serious problem with the plane design.

Flight ET 302 was a scheduled international passenger flight from Addis Ababa to Nairobi.

ET-AVJ photographed in February 2019 ©Wikipedia

The aircraft took off at 08:38 local time with 149 passengers and 8 crew on board – many of the passengers were United Nations staff.

The captain of the plane was 29 yeqra-old Yared Getachew who had been flying with the airline for almost nine years and had logged a total of 8,122 flight hours, including 1,417 hours on the Boeing 737.

He had been a Boeing 737-800 captain since November 2017, and Boeing 737 MAX Captain since July 2018.

At the time of the accident, he was the youngest captain at the airline. But he wasn’t the youngest crew member, that was first officer, Ahmed Nur Mohammod Nur who was, 25.

Nur was a recent graduate from the airline’s academy with 361 flight hours logged, including 207 hours on the Boeing 737.

The fact that the First Officer did not have the usual 1500 hours minimum which most airlines demand may have contributed to the factors leading to this accident. That is clearly speculation – however I’ll read to you from other global airlines minimums

For a major airline in the USA the minimum requirements are typically 1,500+ hours total time, 1000+ hours pilot in command of a turbine aircraft, 1,000 hours multi-engine time, and an ATP rating. The average new-hires have 4,000-5,000 hours total time.

Ethiopian airlines like many other developing nations, is trying to fast-track its own nationals into the cockpit. The lack of experience is only a problem when there’s a problem or a crisis.

And ET 302 had an emergency.  

One minute into the flight, the first officer reported a “flight control” problem to the control tower. Two minutes into the flight, the plane’s MCAS system activated, pitching the plane into a dive toward the ground.  

The pilots struggled to control it and managed to prevent the nose from diving further, but the plane continued to lose altitude. The MCAS then activated again, dropping the nose even further down. The pilots then flipped a pair of switches to disable the electrical trim tab system, which also disabled the MCAS software.

However, in shutting off the electrical trim system, they also shut off their ability to trim the stabilizer into a neutral position with the electrical switch on the top of their control wheels.

The only other possible way to move the stabilizer would be by cranking the wheel by hand, but because the stabilizer was located opposite to the elevator, strong aerodynamic forces were making this almost impossible at high speed.

As the pilots had inadvertently left the engines on at full takeoff power, which caused the plane to accelerate to over 500 miles an hour, there was further pressure on the stabilizer. The only way it would be able to move by hand would be to throttle back significantly which they never did.

The pilots’ attempts to manually crank the stabilizer back into position failed.

Three minutes into the flight, with the aircraft continuing to lose altitude and accelerating beyond its safety limits, the captain instructed the first officer to request permission from air traffic control to return to the airport.

Permission was granted, and the air traffic controllers diverted other approaching flights.

Following instructions from air traffic control, they turned the aircraft to the east, and it rolled to the right. The right wing dipped as the turn steepened – they were beginning what is known as a spiral dive.  

At 8:43, having struggled to keep the plane’s nose from diving further by manually pulling the control wheel, the captain asked the first officer to help him, and turned the electrical trim tab system back on in the hope that it would allow him to put the stabilizer back into neutral trim.

However, in turning the trim system back on, he also reactivated the MCAS system, which pushed the nose further down rapidly.

The captain and first officer attempted to raise the nose by manually pulling their control wheels, but the aircraft continued to plunge toward the ground.

The aircraft disappeared from radar screens and crashed at almost 08:44, six minutes after takeoff.

Flight tracking data showed that the aircraft’s altitude and rate of climb and descent were fluctuating.

Several witnesses stated the plane trailed “white smoke” and made strange noises before crashing. The aircraft impacted the ground at nearly 700 mph.

There were no survivors.

It crashed in a farm field near the town of Bishoftu, 62 kilometres southeast of Addis Ababa.  The impact created a crater about 90 feet wide and 120 feet long, and wreckage was driven up to 30 feet deep into the soil. Wreckage was strewn around the field along with personal effects and other bits from inside the plane.

Personnel from Interpol and Blake Emergency Services, a private British disaster response firm contracted by the Ethiopian government, arrived to gather human tissue for DNA testing, and an Israel Police forensics team also arrived to assist in identifying the remains of the two Israeli victims of the crash.

The black boxes were both recovered on the 11th of March. These were sent to Paris for inspection by the BEA, the French aviation accident investigation agency.

Twenty two people on board were affiliated with the United Nations, including seven from the World Food Programme alone.

Both Addis Ababa and Nairobi have offices of UN agencies, and Addis Ababa has the head office of the African Union.

Notable victims on-board included the Italian archaeologist and Councillor for Cultural Heritage of Sicily, Sebastiano Tusa, and Nigerian-Canadian academic Pius Adesanmi.

Slovak politician Anton Hrnko lost his wife and two children in the crash. All of these families are seeking answers to serious questions and Boeing is in the firing line.

The MCAS system was implicated in the second Crash on 10 March 2019 – following which all 737 MAX aircraft were grounded worldwide.

But it was in China, the EU and Canada that the grounding began – not the United States. This is really a shocking indictment of both the FAA and Boeing. The initial reports clearly showed a real technical problem with MCAS and I followed commercial pilots who were flying the MAX8 and who were extremely angry with both Boeing – and their airlines for hesitating at this point.

The initial report showed that there were two speeds in the cockpit in both cases – indicating the Angle of Attack Sensor was to blame for the initial failure – followed up by MCAS responding aggressively as it was designed. What compounded these accidents was the sets of air crew who had not been trained in MCAS failure of this sort.

But the real problem began with Boeing and its rushed re-design of the 737 which Boeing fast-tracked to compete with Airbus which was making inroads with its A320 single aisle class of plane.

Because the redesigned 737 had bigger CFM International LEAP engines, it meant they needed to be placed higher and further forward in relation to the wing than the previous 737 models.

This destabilises the aircraft pitch at higher angles of attack – so to deal with this, the engineers designed the Maneuvering Characteristics Augmentation System (MCAS) for the 737 MAX series.

Scientific American and the Wall Street Journal reported that former Boeing engineers expressed the opinion that a nose down command triggered by a sensor single point of failure is a design flaw if the crew is not prepared, and the FAA was evaluating a fix of the possible flaw and investigating whether the pilots’ transition training was adequate.

Engineers flagged this is a possible catastrophic failure, but Boeing eventually noted the failure as critical. The first has red flags, the second orange.

This is the crux of the legal case that Boeing will face in the future.

A malfunction in the AoA sensors could lead the MCAS system to believe that the aircraft is stalling when it wasn’t, causing it to dip the aircraft’s nose to recover from a non-existent stall even in level flight.  At high altitude that was bad enough. Close to the ground this was, as we’ve seen, catastrophic.

The terrible fact is that no other plane type since the disastrous Gloucester Meteor crashes of 1966 that the same commercial plane had been implicated in two fatal accidents within five months of each other.

Soon after the Ethiopian Airlines crash,  Brazil, China, and India grounded the Max 8.

The European Union followed shortly afterwards, but the FAA continued to dither which is really unforgivable. The US was particularly slow to act.

While Boeing has announced a new safety process led by veteran Beth Pasztor, their legal problems are only just beginning.

A Congressional panel wants to interview the engineer who filed a scathing internal ethics complaint alleging that company management blocked key safety improvements during the aircraft’s development due to cost concerns.

U.S. House Transportation and Infrastructure Committee members want to interview engineer Curtis Ewbank’s.  The engineer has written a 5000 word report into safety failures.

As a possible cover-up of serious lapses is possible – it appears Boeing kept the Engineers report secret from the Transportation Panel and this along with other obvious mis-steps by the manufacturer are going to come back to haunt CEO Denis Muilenburg and his fellow executives – along with the shareholders.

I’ve reported and followed this story very closely since October 2018 and I am absolutely horrified by Boeing’s actions. As a pilot Boeing is close to my heart, its always been an aircraft that elevated pilot skill above automation – but MCAS is going to be seen as a kind of software driven robot gone mad – combined with a company that preferred quick profits to proper risk analysis.

The damages claims will end up running into the tens of billions of dollars. Boeing’s good name is forever sullied by these two accidents and the company’s muddled response – let alone the FAA’s apparent complicity.

And by the way, in late September 2019 another problem was discovered in Boeing 737 NGs, whch predate the MAX 8.  The pickle fork attaches the plane’s fuselage, or body, to the wing structure and manages forces. A failure of the part in flight could pose a serious risk.

Boeing’s bad news continues.

I’ll be following this story as it unfolds in the future..

Boeing reveals it disconnected crucial Sensor failure alarm on MAX8

Boeing is bracing for another bit of bad news after it was revealed that Southwest Airlines first learned about the crash of a Lion Air MAX 8 that a special alert warning of malfunctioning sensors was no longer a standard feature on the latest 737s.S

According to Federal Aviation Administration officials, they were not aware of this change either.

Boeing 737 MAX8 aircraft have two “Angle-of-Attack” or AOA sensors on the left and right of the plane’s nose. Initial reports on the two MAX8 crashes indicate that in both the right sensor appeared to have been mis-reading the flow of air by up to 60 percent.

Boeing said initially that airlines would have to pay more for the sensor alarm, but what it did not say was that the sensor-failure alarm had been disconnected entirely. But there’s more folks.

Both the Lion Air and Ethiopian Airlines Boeing’s that crashed killing 346 people did not have the alarm failure system which is known as AOA disagree alerts. The big problem is that Boeing and the FAA certified a plane that had no redundant fail-safe.

That is like reading about aviation in 1956. Just after the war, when men were men and pilots were gods of the air, afraid of nothing.

Passengers are much more discerning these days than the early pax – they now have social media to keep them abreast of the latest machine faux pax.

That hasn’t stopped Boeing from acting like it is the middle of 20th Century when it comes to crisis management. What is making things worse for Boeing is the publication of its Emergency Airworthiness Directive in November 2018 after the Lion Air Crash that for some reason, was not escalated properly through the industry.

All Boeing MAX jets, both the 8 and 9, are grounded pending a software fix followed by pilot retraining. Or maybe no pilot retraining, because already Boeing has mobilised its useful twit brigade of aviation bravados to suggest possibly that this is not required.

Yes, dear reader, even in 2019 a large international company based in the U.S.A. is trying to convince reasonable people that there’s no danger in cutting another corner.

Boeing has not indicated why it made the decision to remove the sensor failure alarm. However, the manufacturer was aware of error reading problems.

IN November 2018 it released an airworthiness directive indicating that:

“This emergency AD was prompted by analysis performed by the manufacturer showing that if an erroneously high single angle of attack (AOA) sensor input is received by the flight control system, there is a potential for repeated nose-down trim commands of the horizontal stabilizer. This condition, if not addressed, could cause the flight crew to have difficulty controlling the airplane, and lead to excessive nose-down attitude, significant altitude loss, and possible impact with terrain.”

The airworthiness directive called for aircrews to be provided with runaway horizontal stabiliser trim procedures under certain conditions. But the Ethiopian crew flying the plane in the March crash were not provided with these new procedures.

The Directive also advised that:

“In the event of an uncommanded horizontal stabilizer trim movement,
combined with any of the following potential effects or indications
resulting from an erroneous Angle of Attack (AOA) input, the flight crew
must comply with the Runaway Stabilizer procedure in the Operating
Procedures outlined the following would happen:


Continuous or intermittent stick shaker on the affected side only.
• Minimum speed bar (red and black) on the affected side only.
• Increasing nose down control forces.
• IAS DISAGREE alert.
• ALT DISAGREE alert.
• AOA DISAGREE alert (if the option is installed).
• FEEL DIFF PRESS light.
• Autopilot may disengage.
• Inability to engage autopilot.

If any aircrew experienced these conditions, then Boeing issued the following procedure to recover :

Disengage autopilot and control airplane pitch attitude with control column and main electric trim as required. If relaxing the column causes the trim to move, set stabilizer trim switches to CUTOUT.

If runaway continues, hold the stabilizer trim wheel against rotation and trim the airplane manually.
Note: The 737-8/-9 uses a Flight Control Computer command of pitch
trim to improve longitudinal handling characteristics. In the event of
erroneous Angle of Attack (AOA) input, the pitch trim system can trim
the stabilizer nose down in increments lasting up to 10 seconds.

In the event an uncommanded nose down stabilizer trim is experienced
on the 737-8/-9, in conjunction with one or more of the indications or
effects listed below, do the existing AFM Runaway Stabilizer
procedure above, ensuring that the STAB TRIM CUTOUT switches
are set to CUTOUT and stay in the CUTOUT position for the
remainder of the flight.

An erroneous AOA input can cause some or all of the following
indications and effects:
• Continuous or intermittent stick shaker on the affected side only.
• Minimum speed bar (red and black) on the affected side only.
• Increasing nose down control forces.
• IAS DISAGREE alert.
• ALT DISAGREE alert.
• AOA DISAGREE alert (if the option is installed).
• FEEL DIFF PRESS light.
• Autopilot may disengage.
• Inability to engage autopilot.

Initially, higher control forces may be needed to overcome any
stabilizer nose down trim already applied
. Electric stabilizer trim can be used to neutralize control column pitch forces before moving the STAB
TRIM CUTOUT switches to CUTOUT. Manual stabilizer trim can be
used before and after the STAB TRIM CUTOUT switches are moved
to CUTOUT.

The higher control forces part of this directive are very important, as in both accidents it appears the pilots could not overcome the stabiliser because of air speed.

That is an incredible directive, pointing to the probable causes of both accidents according to both Boeing itself, and initial accident reports.

What we have to ask is this:

Why did the Ethiopian Airline officials not institute this Directive as per the Emergency documentation as soon as possible after the November release?

When both accidents end up in court, which they will, this is going to be difficult for aviation officials to explain. The manufacturer may be to blame for releasing an aircraft to service with a single fail-safe which as we all know is probably criminal.

Using the phrase “hazardous” instead of “catastrophic” to describe the effect of a failure of the system is also going to be quite hard to explain to judges and juries.

Seat squeezing and assorted aviation pastimes

South African Airways squeeze face. No Knee attacker yet, but wait…

Some airlines are reconsidering the whole idea of allowing seats to be lowered after numerous incidents of air rage involving passengers squashed into an area the size of a Houdini escape box.

Thankfully, some airlines have realised that this is no longer acceptable. I mean having a passenger drop their seat back so that you are pinned into an even smaller area, viz the Houdini analogy. Delta Airlines in the USA has decided that the distance a setback will be allowed to travel should be cut by half. That means instead of 4 inches, the setback will drop 2.

Very good. I like flying FlySafair because it does not allow its seats to be lowered which immediately causes friction between the thoughtless twit in front. So often in the past few years I’ve had to deal with males (almost exclusively) who seem to find it funny firing their seat backwards into your solar plexus.

In a flight to Cape Town a few years ago, the twit ahead of me actually pinned my body into my seat and I was forced to push their seat forwards. He pretended not to notice but I slowly used my knees to force his seat back to the upright position.

The game had begun. Would he escalate? He tried to but each time he lowered the seat, my well trained knees pushed back holding it upright. Eventually he gave up.

Now what I do is setup my knees at a certain angle, beyond which no seat shall pass. It’s very useful and the person gives up quite quickly believing their seat recline function is not functioning. Then everyone is happy and on we go.

The pastime known as seat fighting is surely one of the more onerous exercises to conduct in consumer class. First Class members don’t snigger, because Delta is also going to restrict the distance your seats recline too. They’re going to limit the backslide from just over 5 inches to just over 3.

Scream!

Aviation seats are becoming smaller and smaller while passengers are growing fatter and fatter. So this has led to increased friction between people who are forced into these tiny little seats. And then the person in front reclines their seat and shatters your knees.
Knee Defenders – they look like boxing gloves.

Another aviation past time we know and love is the arm rest wrestle. It’s a very simple rule. The middle seat gets to choose to use the arm rests. The window and aisle seats have second bite at the arm rest cherry. It’s all about proper manners, people. The poor sod who found him/herself bracketed by two blokes with large stomachs and fat butts have first right of reply when it is the arm rest.

Back to Delta, it has begun to retrofit its 62 Airbus A320 jets to reduce the seat recline from 10cm to 5cm. First class goes from 14cm to 9cm.

I’ve always liked flying Delta. This is one more reason why.

Here’s a list of other airlines that no longer allow seats to recline:

  • Spirit Airlines
  • Ryanair
  • Norwegian
  • easyJet

If you’re really in the game, then purchase plastic “knee defenders” which can be picked up from the nearest cheap and lousy aircraft kit supplier.

Not sure if the person in the seat in front likes the idea of having your curtain around their setback.

If you’re into privacy, then the B-tourist Strip is for you. A blanket that turns into a curtain which hooks around your seat and keeps prying eyes away from your laptop/breasts.

Trump’s neutered FAA partly to blame for Boeing MAX8 catastrophe

The FAA System Handbook principles of safety effort graphic that compares cost to effort in order to save the most lives in the most cost effective manner.
The FAA Cost vs Safety graph – was it used properly when assessing Boeing MAX 8 sensor failure?

The twin crashes of Boeing 737 MAX 8 aircraft have pointed a very bright spotlight directly on the Federal Aviation Authority along with the world’s biggest aviation company.

And rightly so. While 2017 was free of commercial airliner crashes, only two major accidents have occurred since that year – and both involved Boeing MAX 8s.

In October 2018 the Lion Air crash that claimed 189 lives near Jakarta Indonesia and on March 10 an Ethiopian Airlines crash ET302 that killed 157 just outside Addis Ababa.

Just to put this in perspective, no other commercial aircraft has been implicated in as many deaths so rapidly since 1966.

Since the second accident which appears to have been waiting to happen, all Boeing MAX 8 and 9 aircraft have been grounded, and some airlines have begun to cancel orders. That is a real problem for Boeing. Over 360 are now being used by Airlines across the world, including almost 100 in China alone.

In the days of yore, we would hear about a Russian disaster every few months, now, nada. Nothing. Just two American-built planes gyrating shortly after takeoff, their pilots grappling with an automated system they weren’t told about. What a singularly terrifying experience for the few minutes they had left in life, trying to problem solve clinging onto a bucking bronco.

There is a flood of speculation about the cause, the horizontal stabiliser trim going rogue courtesy of a misreading sensor, about the Manoeuvring Characteristics Augmentation System (MCAS), pilot training and 737 MAX 8 certification.

TRUMP FAILED TO INSTALL AN FAA DIRECTOR SINCE JANUARY 2018

Perhaps we should fixate on the issue which is directly before us: A lack of FAA Director. And because there’s only an Acting Director, there is only an Acting Administrator. This is damaging to flight safety despite what the FAA will say, and the fault lies directly at Donald Trump’s door.

He has failed to install a full-time Director at the FAA preferring instead to hesitate by announcing an Acting Director. Now Dan Elwell may be a superb Airline lobbyist, and a former captain at American Airlines, but he is not the full-time leader of that Agency or else he would have been installed as such. Ditto Carl Burleson who’s technically the second in command. Also acting.

Both are symbols in a cypher-filled world.

Like other agencies, Trump has played politics with people’s lives and in this case, it’s no different. Instead of understanding that leaders are crucial to a proper functioning independent system, he prefers the logic of Mussolini – install a man (probably) who will nod in unison to his demands of loyalty before sanity. Keep ’em guessing. Hahahahaha. “I’ll get around to nominating my puppet when I feel like it…”

Aviation is the one sector where game playing is tantamount to playing Russian roulette with a fully loaded AK47. Trump has been doing just that.

This is not speculation. The FAA last had a full-time director in January 2018. We aviators awaited the new leader of one of the most respected international agencies, which has built its name on a value system around safety that virtually no other can emulate. But in vain. And since then it has committed a gross act of administrative amateurism and been eclipsed in decision-making by the Chinese, the EU and even South Africa’s Comair which pulled its Boeing Max8s before the FAA eventually and begrudgingly agreed to do so.

Ironically because Boeing said so, following a Trump Tweet.

A DANGEROUS GOVERNMENT SHUTDOWN

The result is the FAA failed to process Boeing’s request for an urgent certification of new software in January 2019 following the Lion Air Crash in Indonesia that killed 139 people in October 2018. That’s because the Agency was hamstrung by the government shutdown, caused by a president who ignored his own advisors and refused to sign an extension of spending deal because he didn’t get money for a wall.

That is a bit like a baby throwing its toys out of a moving aircraft directly at the people walking across a tightrope at 37 000 feet.

I don’t care for American politics much, it’s a place that appears to be a step away from full-blooded violence. In its place is a media civil war between the Democrats led by people like CNN, and Republicans led by people like Fox. Attend any dinner in America these days and you’ll hear both sides quote their favourite “facts” about why the other side is conspiring in some way or other. Both are dripping in diatribe and distastefully biased, dumbed down, feckle-minded and draped in self-indulgence. It’s like watching dogs with down syndrome.

But what really has happened is that authority has been destroyed as Trump allowed the FAA to wallow in a kind of blind holding pattern.

While the speculation around airlines not purchasing redundancy, their MAX 8 simulators missing the crucial MCAS training software (upgrade to follow FAA/Boeing getting a wriggle on), the fact that in both crashes the First Officers were far less experienced than is usually the case (a few hundred hours total flying time), and a failure to laterally think, it really is about how the hell did the FAA pass Boeing’s new plane as good to go for pilots just to read a few pages on an iPad?

I find this shocking, and there is no way around this moment, folks.

Why did the FAA basically allow Boeing in 2016/17 to conduct its own safety audit of the new system? Why did Boeing cycle through a few senior staff who warned that the MCAS could lead to a Catastrophic result if redundancy was not ensured by duplicating sensors? Eventually they found senior staff who were willing sign their names alongside the phrase “Hazardous” when the safety handbook outlined the threat as “Catastrophic”?

The FAA published a handbook in 2000 outlining what is the cost of safety versus a hazard analysis. Here is the safety section.

Table 3.2.2 of the Severity Definitions for FAA AMS Process. Someone really screwed up here by citing the Boeing 737 MAX8 sensor failure as “hazardous” when it was actually “Catastrophic”.

Why was this not used by the FAA? It preferred to take Boeing at its word?

A SIMILAR EXPERIENCE IN A PISS CAT

Let me expound. As a pilot of Cirrus SR20 and SR22 aircraft, I am not in the world of Commercial Aviation, I’m a General Aviation pilot. What professionals call the pilot of a “piss cat”. These cats that wee, however, can surprise even the best of ATPL trained 10 000 hour wonk. That’s why some of my friends who fly airlines, also fly .. piss cats.

It keeps you alert, makes you think, gives you real stick feel for how an aircraft is responding. Makes you lateral when all about you are literal. And the more computers you get, the more literal you get.

Recently a new Garmin 1000 SR22 was introduced to the bunch of planes for rent at a hangar I fly from, and I dutifully signed up for a conversion. This was a 2 hour minimum conversion because of two main reasons.

  1. The Garmin 1000 is a tricky beast when you’ve used Avidyne Avionics and Garmin 430s.
  2. The new Cirrus has an automated roll recovery installed.

It’s point 2 that I want to explain. And it’s one of the reasons why the FAA and Boeing are now in a spot of bother. Cirrus is safety obsessed as their airplanes are slippery beasts when everything is high and hot. IF you get the numbers wrong, you’ll incipient spin into the deck at low altitude.

So I had to take off and fly the Cirrus with Garmin 1000, and do a beyond steep turn passed 60 degrees, to feel the crazy sensation of a plane pulling you back to safe and level EVEN THOUGH THE AUTOPILOT WAS DISCONNECTED.

I was truly shocked and amazed. I asked the instructor where I could switch off this automation and he said proudly

“You can’t”

“What happens” I said “If I’m flying straight and level and because of a sensor misread or software malfunction, it suddenly decides to turn me to the right or left believing I’m in a turn too steep?”

“It won’t happen” he said.

I made a mental note to approach other instructors in future when conducting further training.

Since that conversation I look askance at the aforementioned Cirrus, while flying it I’m always aware that the plane may decide to take over my flying duties without my permission.

The reason why I do so is because it has a CAPS system – a rocket that fires a parachute out of the top of empennage that will save my life if the plane decides to be stupid. I have a redundancy to cover the eventuality that the computer on board goes rogue, thus I will continue to fly the Cirrus with Garmin1000 and automatic roll recovery and deploy ‘chute where necessary.

Unfortunately for the pilots on board both Boeing MAX 8s – no-one had a parachute.

Two Boeing 737 MAX crashes an ominous sign for the company

Ethiopian Airlines ET302 accident site.

A Boeing 737 MAX operated by Ethiopian Airlines, flight number ET302 has crashed shortly after take off from Addis Ababa airport killing all 157 on board.

The initial reports sound ominous for Boeing. While it’s far too early to talk about the cause, it’s not too early to talk about the second time the same type of aircraft has crashed in similar circumstances.

The accident is similar to last year’s crash of a Lion Air jet that plunged into the Java Sea in October 2018, killing all 189 people on board. These two crashes involved the Boeing MAX 8 aircraft. The Seattle based manufacturer is working with investigators in the Lion Air matter.

Boeing was forced into a speedy production process when Airbus announced its new Airbus A320neo family of aircraft with improved fuel burn and operating efficiency. It took six year between 2011 and 2017 for Boeing to redesign, build and gain certification from the FAA for its new 737’s.

As usual the testing process was comprehensive. For example the Boeing MAX’s were put through 2,000 flight hours as well as three hours of ETOPS testing.

Three thousand simulated simulated flight cycles were conducted and at first there were a few problems with the engines. For one, they were delivered late by manufacturer CFM International. It was a joint venture between GE Aviation and Safran Aircraft Engines, a division of Safran of France.

The first delivery was a MAX 8 was to Malindo Air, a subsidiary of Lion Air in May 2017. Just over a year later, the Java crash occurred.

Source: Wikipedia

Norwegian Air also flies the MAX 8, and after a one year of service, 130 of these redesigned planes had been delivered to 28 airlines or customers and logged over 41 000 flights in 118 000 hours – flying over 6.5 million passengers.

After 2017’s spotless aviation record with no major aviation crashes, things changed on October 29, 2018 when Lion Air Flight 610 plunged into the sea 13 minutes after take off from Soekarno-Hatta International Airport in Jakarta, Indonesia.

This was the first crash involving a 737 MAX, and the aircraft was only delivered two months before the accident.

Afterwards, Boeing issued a safety bulletin advising airlines about how they should approach the automated systems which are now thought to have caused the Lion Air crash.

The FAA also issued an emergency airworthiness directive followed quickly by Boeing’s update for flight crew operations. The company said there could be a fault in the aircraft’s angle of attack system that could cause the aircraft to violently pitch nose down. What terrifies pilots is that this could even occur AFTER the automatic pilot was switched off and pilots were hand-flying the aircraft.

Ethiopian Airlines Flight ET302 path

Sensors in the aircraft apparently caused false data to be fed to the aircraft’s computer system, leading to it taking over the flight controls from a pilot even after he or she switched off the automated systems. The data erroneously reported that the plane had entered a stall, when in fact it was flying faster than the stall speed and the wings were not stalled at all.

This is catastrophic for aviators when faced with a threat at low altitude. You just don’t have time to press all the buttons, and I really feel for the pilots in both aircraft it it is indeed proven that the automatic system caused these crashes. It now appears that the electric stabiliser trim is what could have been pushed forward – and flight crews are told to switch these off when they hand-fly the plane.

Switching to manual trim is always the best way to fly, but in today’s busy cockpit perhaps in both instances the captain and first officer were concentrating and may have not had time to switch off the electric trims.

There are more similarities. Ethiopian Airlines 737 MAX had only been delivered four months ago.


A Chandler holds no candle to SAA’s William

William Chandler is his name, fakery is his game. Or at least that’s according to South African Airlines in a statement issued on Friday 1 March 2019.

While the official holder of a Commercial Pilot’s license, those who wish to fly airlines must be in possession of something much more impressive – an Airline Transport Pilot’s License or ATPL.

“It is an SAA requirement that all pilots obtain an ATPL license within five years of their employment as pilots at SAA,” an airline spokesperson said.

“This is linked to Senior First Officer status and forms part of their conditions of employment as regulated in the SAA Pilots Regulating Agreement. Any pilot failing to obtain this license, will have their employment terminated with the airline.”

That rather officious comment belies the seriousness of the offense. After clocking up thousands of hours as a First Officer starting in 1994, he refused an offer of a major promotion in 2005. That would have exposed him as he would have had to hand over his ATPL certificate – which he does not have.

Fortunately for thousands of passengers, they survived flying with a measly commercial pilot, but unfortunately for Chandler – he must now repay the millions of rands in perks he received from the airline. Not to mention he faces charges of fraud at the very least.

But the story worsens, as this man apparently was the First Officer at the controls and monitoring Flight SA206 between OR Tambo International to Frankfurt in Germany in November 2018.

Something went badly wrong or his actions apparently caused one of the other pilots, possibly the Captain, to report him.

The threat two passengers was minimal, as Chandler had clocked many hours flying the various aircraft SAA uses – and had recently passed a number of tests and checks.

So he can fly alright, but the problem is he is not supposed to fly airliners. The major problem for the airline is had he been involved in a much more serious incident involving passengers – insurance and other problems would have arisen.

A Chandler, for those who don’t know, is a person who makes candles for a living.

Here is a definition

“A chandler was the head of the chandlery in medieval households, responsible for wax, candles, and soap. Chandler may also refer to: Candlemaker or chandler, an occupation. Ship chandler, a dealer in special supplies or equipment for ships.”

Perhaps Mr Chandler will now consider this a future profession as he finds ways to pay back the money.

Emiliano Sala reportedly on board Piper Malibu that disappeared

A Piper Malibu – similar to the plane Emiliano Sala was reportedly traveling in when it went missing on the evening of 21st January 2019.

At exactly 20.23 on the 21st January 2019 Guernsey Coastguard received an alert from the island’s ATC that a light aircraft had disappeared off their radar 15 miles north of Guernsey.

The terrible report has been followed up by Welsh football club Cardiff City which issued a statement saying they have ‘genuine concerns’ over the safety of their new record signing, Emiliano Sala.

From mid-morning on the 22nd, two helicopters, two planes and one lifeboat were reportedly searching for any sign of the missing plane.

It is thought to be a Piper Malibu P-46T, which is a single engined turbo-propellor driven aircraft which had reportedly taken off from Nantes in France and was flying to Cardiff in Wales.

Two people were on board according to French officials, Sala and the pilot.

A search model has been created based on the likely ditching location and an intense search is now underway.

The weather conditions after the disappearance worsened rapidly, but it is believed the aircraft was flying at 5000 feet and following VFR rules. After passing Guernsey the pilot reportedly asked ATC for permission to descend, then contact was lost as it flew around 2300 feet.

That is low flying in anyone’s book. What was a multimillion dollar sportsperson doing in a plane flying so low?

French journalists have confirmed that Sala was seen walking through border control in Nantes and it is believed he was on board the Malibu. Some hacks have described the aircraft as a private jet, but it isn’t. It’s a turboprop.

Nantes to Cardiff likely route – ignore the time it’s Google offering a flight via a small plane.

Cardiff City, known as the Blues, unveiled their new fifteen million euro Argentinian player only last week, and he had returned to France after Saturday’s announcement with a view to flying back to Cardiff last night.

Other pilots flying a similar route report some icing around 3000 – 5000 feet and wind shear between 2000 feet and 2500 feet. However it was not deemed dangerous. Clouds were reported at 5000 – 6000 feet, well below the level the Malibu was believed to be operating.

The search continues.

UPDATE: Tuesday 5 February

Piper Malibu N264DB

A body has been spotted in the wreckage of a plane carrying Cardiff City footballer Emiliano Sala which was discovered in the English Channel after a short search.

The Piper Malibu N264DB disappeared on 21 January en route between Nantes in France to Cardiff in Wales with the Argentine striker on board.

The only other person aboard the Piper was the pilot David Ibbotson.

Marine Scientist David Mearns assisted the Sala family and said the aircraft had been located off Guernsey on Sunday.

On Sunday February 3rd 2019, Mearns posted tweets including one which said “The families of Emiliano Sala and David Ibbotson have been notified by police.”

He was referring to the discovery of a substantial portion of the plane wreckage. A submersible UAV craft was sent to inspect the wreckage and afterwards officials said that a body had been seen in footage.

But they would not be drawn into any further comment.

Cardiff City football had signed Sala for a record of £15m and he was due to start training at the end of January.


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South Africa’s Space Weather coup eclipsed by Schweizer-Reneke

South Africa scored a major scientific coup on Monday 14th January 2019, but it appears the Hacks of Habit aka local media thought stories about DJs being naked or some kids in a classroom were more important.

Now don’t get me wrong, the Schweizer-Reneke story about four black kids perched at the back of the class separate and unequal is unforgivable.

At the same time, it was also a useful distraction for habitual Hacks who apparently think science stories are far too complex to think about while contorting yourselves into whirling pools of screaming self-righteousness.

And how shareable on social media to boot? So many media outlets happily shared the picture, although it was quite clear those in the picture were far too young to be scrutinised. Technically this broke the Media Code, but that’s another story.

A quick scan of local media headlines on the day showed just how utterly landlubbered and bereft of imagination these gatekeepers of self-importance were. The only real coverage was on ITWEB, some government websites and Engineering News.

That was about it for headlines.

The rest thundered off into an intellectual dead-end, trying to outdo each other to get exclusives about a story that everyone already had so that the huffing and puffing lower middle class could exhaust itself and its expensive data exchanging redundancies on the social media platform of choice.

How pathetically South African.

The North West town is named after a Swiss man called Reneke by the way.

The hullabaloo overshadowed a moment of national interest. The really important story on Monday was the one about the South African National Space Agency (SANSA) being selected by the International Civil Aviation Organisation (ICAO) to become the designated regional provider of space weather information to the entire aviation sector in Africa. Almost a billion people. Forget Schweizer-Reneke and its Swissness, population “a few”.

This is much bigger news for South Africa than a North West junior school, but it involves real science and therefore the average South African editor is immediately, and apparently, disadvantaged.

SANRA’s windfall is our national pride, people. It means all aircraft flying anywhere across Africa will now rely on SANSA for space weather information.

All pilots know that the usual terrestrial weather systems are crucial to being able to take-off and land. Also crucial, is the various radio/radar/GPS/GNSS systems on board that allow pilots to navigate and communicate.

SANSA is to partner with one of the ICAO’s three global space weather centres, Pan-European Consortium for Aviation Space Weather User Services or PECASUS. The only other is controlled by Russia and China which may decide to use the information, let’s just say, not in the interests of science in Africa.

PECASUS falls under ICAO, the international Aviation organisation. The Department of Science and Technology issued a statement about this on Sunday afternoon which trumpeted the advantages for the country.

“South Africa’s designation as a regional space weather information provider will grow the science, engineering, technology and innovation sector, offering opportunities to develop scarce skills and increase national research output, while ensuring that usable products are generated from the knowledge,” it said.

SANSA open day.

Space weather can be pretty grim. Huge surges in sunspot activity send radio waves streaming out across the solar system, hammering earth. These can be extremely violent.

These were first really understood many years ago, in 1859. That’s when an amateur astronomer called Richard Carrington climbed up into the loft of his country estate, opened the dome and pointed his telescope at the sun.

He was keeping tabs on large sun spots, when suddenly two gave off what he called “… intensely bright and white light” and after five minutes they vanished.

That night, telegraph communications across the world failed. Sparks were reported from some, others set papers on fire and auroras were experienced all over the nighttime sky, glowing brightly. Birds woke up believing it was dawn these were so bright.

This was known as the ‘Carrington Event’.

In 1972, a similar event knocked out AT&T systems in the USA and led to the company redesigning its entire subsea cable operation. In March 1989, a powerful solar flare set off power blackout in Canada that left six million people without electricity.

Then in 2000, the Bastille Day event occurred – July 14th to be exact. This registered X5 on the solar flare scale (yes there is one) and caused satellites to short circuit, while some radio stations stopped broadcasting.

Then in October 2003 our nearest star (yes, the sun) unleashed a hefty uppercut across the solar system. This made the Bastille Day event seem insignificant. The spacecraft measuring flares blew up, and eventually all sensors topped out at X28, but later it appeared the flare actually reached a peak strength of X45.

©NOAA

So you begin to appreciate South Africa’s importance in aviation. We are the only country in Africa with space weather capabilities, so it makes sense for SANSA and PECASUS to work together for the good of aviation on the continent.

“The country’s space science programme is feeding the knowledge economy and placing the national system of innovation at the centre of South Africa’s developmental agenda,” the department added. 

Just in case you think this space weather thing is not serious, a note from my Aviation files will serve as a warning.

“Space weather refers to the conditions on the Sun and in the solar wind, magnetosphere, ionosphere, and thermosphere that can influence the performance and reliability of space-borne and ground-based technological systems and can endanger human life or health.”

Modern aviation now relies on flights over the Arctic, whereas during the Cold War, China and Russia did not. But Space Weather affects the poles far more than anywhere else, so it’s even more important to watch this phenomenon now. At the same time, each burst of energy from the sun can impact the earth based on when these electromagnetic rays strike the globe.

The effects include loss of HF radio transmission and satellite navigation signals, navigation system disruptions and general avionics errors. Flight planning includes space weather for a reason.

So as you prepare for your next flight over the equator and into Europe or Dubai, to catch the next flight out to San Francisco, consider the work SANSA will be doing with PECASUS and NOAA.

Makes me proud.