2008-01-18Staff Report 2 "By Dr Moses Amweelo An accident is an unexpected, unplanned and unwanted event that disrupts work and may result in human injury or death, damage to property, loss of production, time and money. It follows therefore that occupational ergonomics must be developed and improved to prevent accidents and injuries. This is done by removing hazards, reducing the probability of accidents and minimizing the severity of accident consequences. This article will study and take the above into consideration, regarding aircraft accidents and injuries in Namibia. We have experience of an aircraft that crashed into a house, bursting into flames and killing all five passengers and one pilot on January 11, 2008 at around 16h23 UTC (Universal Coordinated Time), shortly after the plane departed from Eros Airport en route to Mokuti Lodge. The aircraft (type registration and serial number, Cessna 210, V5-GWH), sustained major damage beyond repair, since it was destroyed by the fire after the crash. The Director of Aircraft Accident Investigations in MWTC said that he had assigned investigators in order to establish the cause of the accident. Some eyewitnesses interviewed by investigators claimed seeing fire coming from the aircraft's engine before the crash, but the real cause will only be determined after scientific investigation is conducted (The Namibian January, 14, 2008). Basic industry statistics - November 1998 to July 2001 Parameter - Civil aircraft registered were 446 in 1998, 473 in 1999, 490 in 2000 and 504 in 2001. - Aircraft maintenance engineers (licensed) were 40 in 1998, 45 in 1999, 51 in 2000 and 68 in 2001. - Pilots were 720 in 1998, 823 in 1999, 872 in 2000 and 983 in 2001. - Aircraft operators were 56 in 1998, 69 in 1999, 71 in 2000 and the same figure in 2001. - Maintenance organizations were 27 in 1998, 24 in 1999, 21 in 2000 and 21 in 2001. - Incidents were *102 in 1998, 107 in 1999, 149 in 2000 and 64 in 2001. - Accidents were *4 in 1998, 6 in 1999, 10 in 2000 and 6 in 2001. - Aircraft mass more than 5700 kg (occurrences) were *24 in 1998, 39 in 1999, 51 in 2000 and 28 in 2001. - Aircraft mass less than 5700 kg (occurrences) were *82 in 1998, 74 in 1999, 108 in 2000 and 42 in 2001. - Non-fatal injuries were *6 in 1998, 6 in 1999, 6 in 2000 and 7 in 2001. - Fatal injuries were *0 in 1998, 1 in 1999, 3 in 2000 and 0 in 2001. NB! These are 'annualized' figures because complete statistics for the whole year have not been completed. Detailed records compilation commenced in November 1998. These are figures up to July 2001. Further breakdown of each parameter is usually made for a clearer picture of what is occurring (ICAO Circular 276-AN/162, 1998). For example, the number of pilots in Namibia can further be broken down into: Student Pilots, Commercial Pilots and Airline Transport Pilots. The International Civil Aviation Organization's long-term commitment to aviation safety has come a long way in making air travel a safe form of transport. This is demonstrated in the improving trend of both aircraft accidents and passenger fatalities over the years. According to the aircraft Crashes Records Office of Geneva, the death toll of over 1 300 people from air accidents in 2002 was the lowest since 1947. I would like to categorically state that although only 17 years old, the Republic of Namibia has been a proud member of ICAO since 1991. To this end, Namibia has and continues to contribute to the development of civil aviation in a safe, secure and orderly manner despite the fact that civil aviation is passing through some of the most turbulent times in its history as a result of the economic downturn. In order to assure ""Safe Skies"" Namibia has trained and continues to train its air traffic controllers to the highest standards. The National Civil Aviation Administration has upgraded its air traffic communication equipment, and has recently embarked upon a project aimed at acquiring surveillance capability. In order to comply with the Standards and Recommended Practices (SARPs) set out in Annexes 1, 6 and 8 as well as related procedures, Namibia has in place primary aviation legislation, new regulations, technical standards and procedures enabling the Director of Civil Aviation to carry out safety oversight responsibilities. Accident Analysis Accident analysis is a systemic approach to identify hazards and prevent accidents before they occur. Different methods of analyzing are in use, such as hazard analysis, risk analysis, reliability analysis and to a broader extent, total control and risk management. Once an accident has been investigated, the next step is to perform a thorough accident analysis. Although the depth of analysis will vary, depending on the seriousness of the event, some basic guidelines are summarized below: - do not fix blame for an accident, merely state the causes; - be factual as far as possible in specifying the causes; - look for the primary and secondary causes of the accidents, not the symptoms. The first guideline is essential. In order to obtain facts, communication between workers, supervisors and informed employees must be open. The second guideline is particularly useful if opinions vary. Extra care should be taken to obtain the views of everyone involved in the accident or near the accident site. The last guideline deals with determining the cause or causes of the accident. These causes are defined as either unsafe conditions or unsafe acts. If the primary and secondary causes are known, the next step is to implement the suggested corrective measures so as to eliminate the effecting factors. Reporting of Accidents (failures, malfunctions and defects) According to the Namibian Civil Aviation Regulations, 2001, Part 21 Subpart 21.01.3 (1) the holder of any type certificate, supplemental type certificate, production certificate, NAM-PMA or NAM-TSO authorization issued in terms of the regulations in this Part, shall report in writing to the directorate any failure, malfunction or defect in any product, part or appliance manufactured by such holder which: - Has resulted in any of the occurrences specified in Document NAM-CATS-AR; or has passed through such holder's quality assurance system and may result in any of the occurrences specified in Document NAM-CATS-AR. A report referred to the above shall include: - The aircraft serial number; - If the failure, malfunction or defect is associated with an article approved under a NAM-TSO authorisation, the article serial number and model designation; - If the failure, malfunction or defect is associated with an aircraft engine or aircraft propeller, the engine or propeller serial number; - The product model; - An identification, including the part number, of the part, component or system involved; and - The nature of the failure, malfunction or defect. Aviation safety studies of course are generally far more complex and sophisticated. Upon completion of the investigation, reports are released to the Public and the Aviation Regulatory Body (the Directorate of Civil Aviation). As the aviation regulator, the Directorate of Civil Aviation (or DCA) is normally tasked with developing the aviation safety programmes for implementing the recommendations made in the reports. According to the paper presented by Charles Higgins Vice President of Airplane Safety: Boeing Commercial Airplane Group, aircraft accident investigation reports typically cite several causal factors and refer to a complex series of events, or missed opportunities for intervention, that ultimately led to a tragedy. Therefore application of a simple, straightforward ""fix"" is not usually indicated. Solutions require an overall systems approach where all the casual factors, and other factors are considered along with associated risk and the feasibility of a remedy. Sometimes a proposed ""fix"" adds cost and complexity without a concomitant improvement in safety. Poorly thought-out ""fixes"" may even introduce additional risk. Conclusions and Recommendations The recommendations mainly fall under the following categories: - Aviation safety training improvements (e.g. air navigation procedures, information on airfields, etc.). - Aviation maintenance safety improvements (e.g. adjustments to maintenance schedules, improvement of aerodrome equipment, etc.). Some recommendations obviously fall outside the direct jurisdiction of the Directorate of Civil Aviation (DCA) and the latter then serves to act as a facilitator or coordinator for the implementation of such recommendations. An example of this would be a case where an aviator deliberately disregards mandatory regulations and thereby causes a danger to safety. In this case the police would best be suited to handle the situation and the DCA would serve as an advisor to the police and the Attorney General. Aircraft accident and incident prevention has now become a major priority for civil aviation in Namibia. The Directorate of Civil Aviation and the Aviation firms (Maintenance, Operators, Trainers) are systematically developing and improving their Aviation Safety Programs independently and co-operatively in response to aircraft accident/incident investigation reports. Finally, I would like to recommend that the Directorate of Civil Aviation must be transformed into the Namibian Civil Aviation Authority (NCAA) with the legal status to carry out its safety oversight responsibilities on behalf of the MWTC in a more cost-effective manner. The NCAA will be in a position to attract and retain suitably qualified technical staff that combine both the professionalism and integrity required to make civil aviation in Namibia a competitive employer. " 2008-01-18Staff Report 2
