global occurrences). Non-scheduled flight in Bangladesh BAF Flight - - PDF document

PRESENTATION ON BAF/NATIONAL/GLOBAL FLIGHT SAFETY ISSUES BY DIRECTOR OF FLIGHT SAFETY 36TH COMMAND SAFETY CONFERENCE Bismillahir Rahmanir Rahim,

• 1. Chief of Air Staff, Principal Staff Officers, Air Officer Commanding from different Air

Bases, Distinguished guests from different aviation organizations, ladies and gentlemen. Assalamu Alaikum and good noon.

• 2. On behalf of all the members of Directorate of Flight Safety, I feel privileged to

welcome you all to the 36th Command Safety Conference. I take this opportunity to express my sincerest gratitude to Chief of Air Staff for his kind presence.

• 3. The scope of Flight Safety is unlimited, the rooms for improvement is a continuous
• process. Today, with the advancement of modern technology, Flight Safety has become a

bigger challenge and merely not limited to a specific boundary but has been expanded

• globally. Sharing of knowledge and experience is one of the major tools to enhance

existing Flight Safety method.

• 4. The aim of my to-days presentation, ‘To exchange ideas and views on BAF, civil

and Global Flight Safety issues".

• 5. For next 25 mins or so I will cover my topic following the sequence unfolded on the

screen. Sequence of Review  Civil Airlines Flight Safety statistics of the year 2012 (In this part, I would like to provide the statistics and the analysis of the crucial safety aspects for the year 2012. This would allow us to appreciate our standing in light of the global occurrences).  Non-scheduled flight in Bangladesh  BAF Flight Safety trend Last 30 Years  BAF Flight Safety record 2012  Flight Safety threats in an environment of limited resources  Flight Safety trends of USAF

• 6. Ladies & Gentlemen, Flight International Journal has published a safety overview
• f the global airline safety in its January edition where the year 2012 is regarded as “a freak

year for safety” in the eyes of experts on both safety and insurance. According to Flight global's Ascend consultancy, 2012 was an anomalous year for world airline safety. It was so good compared with all previous years that it is unlikely to be equaled for some time.

• 7. Ladies and Gentlemen, according to the Flight International Magazine Jan

2013 edition, there were 21 fatal airline accidents in 2012, resulting in a total of 425

• deaths. This compares with respective figures in 2011 of 32 fatal airline accidents and

514 deaths.

• 8. Special Bulletin analyzing airline safety performance last year says, 2012 was another

good year for safety, with the fatal accident rate falling from about 1 (one) per 1.4 million flights in 2011 to 1 (one) per 2.3 million flights in 2012.

• 9. Let us first see the state of the fatal accidents and fatalities of the last 10 years in

global airline industry to understand the significance of year 2012. Blue line is the number of fatalities and the Red line is the number of fatal accidents. In the year 2003, the number of fatalities was 702, and number of fatal accidents was 27. In 2008, the number of fatalities was 583, and number of fatal accidents was 34. But, if you compare this statistics with 2012, you can see, the number of fatalities was 425, and number of fatal accidents was 21. Last 10 years rate of fatal accident is 28.2 and average fatalities are 691. By this, I think you can understand how exceptional the graph of 2012.

• 10. So, very well we can say that 2012 was certainly the safest year ever and on the face
• f it, 65% safer than 2011, which itself had been labeled, "The Safest Year Ever". Ladies

and Gentlemen, if you look on the graphical statistics of World Airline Fatal Accidents and Fatalities from 1992-2012, vertical line shows the number of flights in million. In the year, 1992 the rate of fatal accident was only one in 0.575 per million flights, in the year 2000, it was one fatal accident in one million flights, and finally in 2012, it one fatal accident in 2.4 million of flights.

• 11. Ladies and gentlemen, here you can see some of the images of fatal accidents
• ccurred in 2012.
• 12. Now, let us watch a video clip on so far considered to be the Top five fatal accidents.

(VIDEO)

• 13. However, unfortunately, we do not believe that the world's airlines have suddenly

become this much safer and 2012's accident rate, perhaps, should be considered more of a fluke than the normal one. The logic behind this reasoning is very simple. Although, the statistical graph shows 2012 was almost twice safer than 2011, but since the aviation industry did not implement any special safety measure that could account for such a dramatic improvement.

• 14. Ladies and Gentlemen, let us see what are the possible factors responsible for fatal

accidents of 2012. There are total 10, out of 21 fatal accidents occurred in the proximity of the destination R/W, mostly for bad weather and misjudgment by the pilots, which is almost 50% of the total accidents. The rest 50% accidents occurred due material failures and other

• factors. So, lets talk about the 50% accidents occurred due pilot and environmental factors.

As per safety review done by Flight International magazine, as in recent years, 2012 accidents were almost all precipitated by pilot mis-judgment or mis-management.

• 15. As a leading article in Flight International stated: I quote “Pilots are the systems

goal-keepers, but the system keeps banging own goals past them.” I unquote. Individual

• rganizations such as the Royal Aeronautical Society and the Flight Safety Foundation may

be studying the subject of how pilot training needs to be improved, but regulations are showing little interest in mandating change, specially on a global basis.

• 16. The another factor for fatal accidents and the contrasting low fatalities is the number
• f small regional aircraft involved, mostly turbo props having relatively less passengers
• nboard. Indeed, statistically, the small, local operators have been stated as most vulnerable

to accidents. Such statistics demand increasing safety awareness for the booming aviation industry of Bangladesh which features mostly small passenger aircraft.

• 17. On the other hand, in case of non-fatal accidents and serious incidents, runway

excursions or over runs still appear to be the most common accident category, although it is too early to say whether the worldwide campaign to raise awareness of runway excursion risk is having any noticeable statistical effect. A significant number of the excursions involved landing on wet or otherwise contaminated runways, with the approaches carried out in stormy

• conditions. The aviation industry continues to face lesser number of fatal accidents even in

the face of increasing number of flights across the world. As a member of global aviation industry, our civil aviation industry also shares a tiny fraction of this credit. Such trend is very much stimulating and rewarding for the flight safety goal of our booming aviation industry. Ladies & Gentlemen,

• 18. Having said so, let us see in which aspect we are likely to face new challenges within

the changing dynamics of aviation industry in our airspace? The most imposing change we have been encountering in the recent time is the increasing number of scheduled and non- scheduled flightoperating within our airspace.

• 19. The slide provides a general idea on the trend of number of flight in Bangladesh Air
• Space. Not only the statistics reflect a steady increment of non-scheduled flight, but also the

scheduled flight reflects a trend of increasing number of flight. As you can see the month wise non-scheduled flight statistic in the year of 2012.

• 20. Here you can see the last five years comparison of non-schedule flight in Bangladesh

air space. The possibility of occurrences is not far from happening if the existing safety measures are also not increased.

• 21. Now, I shall deliver BAF’s safety trend. Before the overview of the incidents of year

2012, I would like to present the total flying effort BAF has put in the last 30 years. In the first 15 years, beginning from 1982, every year BAF continued to generate more flying hours than the preceding year. For example, BAF achieved more than 8,700 hours in the year 1982 for which a total of 50 occurrences took place. By the end of 1996, the total hour achieved was 15,800 hours for which 90 occurrences took place. The flying effort actually doubled in this 15 years period. Expectedly, the number of occurrences increased with the increment of flying hours achieved. The average yearly occurrence rate from the year 1982 to 1996 numbered little more than 56 against yearly average flying of 12,500 hours as you can see

• n the screen. The average yearly flying hours from year 1997 to 2012 is little more than

20,000 hours. The average of occurrences for this period happened with little more than 76 per year. We have increased our flying effort by 80% in the last 15 years. In contrast, the average yearly occurrence increased by 30% only. The figure indicates improvement in flight safety because of the fact that the occurrence rate was brought down despite high rate of

• flying. The most damaging aspect of the period 1982-1996 was the number of fatalities that

we experienced within that period. A total of 34 persons were killed out of the accidents. That makes the fatal rate of 2.23 per year. The figure was quite scary for a small Air Force like us. However, from the point of fatality, the figure stands as 15 in the last 15 years making 1(One) as average yearly fatality. The safety trend in BAF has improved in terms of fatality.

• 22. Now, I will switch to the flight safety review part of BAF for the year 2012. Month-

wise trend of aircraft occurrences for the year 2012 which is shown on the screen: Ladies and Gentlemen, As you can see the graphical statistics of BAF ac occurrences, the number of occurrences has been suddenly increased in the month of March, then onward rate

• f occurrence decreases. But again it increased in the month of Dec. However, we are to take

lesson out of it, specially the time frame where the probability of occurrences is more.

• 23. Now let us see ac wise occurrence per thousand hr of BAF for the year 2012. As

you can see on the slide, the FT-6 ac has got the highest rate of occurrence which is 22.59%,then Mig-29 ac, 14.9% and An-32 ac has got the lowest rate of occurrence per thousand hrs,0.73%.

• 24. I will go over the factor wise comparison of occurrences of last 5 yrs. As you

can see on the slide, the total number of occurrences is more than the previous year but the avoidable pilot and maintenance factor has been reduced than of last year, where as the number of material factor has been increased.

• 25. Now let us look on to the factor wise trend of ac occurrences. As I have mentioned

already the matter of concern for the year 2012 regarding occurrences is the Material factor which is 80.95%, then environment factor 14.29%. The pilot and maintenance factor has got the equal share i.e. 2.38%.

• 26. Irrespective of the improved safety record, the incidents of the year 2012, like every

year, have left many lessons to learn. It is important that we take note of these lessons and consider their applicability for both the military and civil aviation sector of Bangladesh. To maintain and improve upon the safety trend, BAF takes many programs like Observe Flight safety week twice in a year, award good shows and Green Endorsements for the air and ground crew, regular FOD drills, holding squadron and Base flight safety meetings, Command Safety Conference once in a year, international safety seminar once in 2 (Two) year and also publishing safety journal “BLUE ANGEL”.

• 27. In the year 2012, 07 BAF officers, 02 BAF airmen, 01 officer from Bangladesh Navy

and 01 Flight Cadet received “Good show” for their excellent contribution to flight safety. Moreover, 24 aircrew received “Green endorsement” certificates for their accident free flights. In addition, 01 aircrew received “Special Green Endorsement” for his exemplary demonstration of calmness and confidence to handling an aircraft emergency.

YEAR TOTAL AVOIDABLE UNAVOIDABLE PILOT MAINT MAT ENVIRON UNDETER 2008 76 05 05 51 09 03 2009 75 09 04 54 07 01 2010 81 04 07 61 07 02 2011 78 06 03 54 14 01 2012 84 02 02 69 11 Nil LAST 05 YEARS AVERAGE 5.20 4.40 57.60 9.60 1.40

• 28. Ladies and gentlemen, coming 25th and 26th November 2013 BAF and CAAB is going

to organized jointly International flight safety seminar-2013 in this Falcon Hall. This time the theme of the seminar is ‘Standardization Improves Flight Safety’. Ladies and Gentlemen, let us overview flight Safety from a different dimension like Flight Safety threats in an environment of limited resourcesas it is very much applicable to our

• environment. I humbly acknowledge Col Ron, the Head of Aviation Safety Division, Royal

Netherland Air Force who has developed this concept having experience of 50 years statistics

• n Royal Netherland Air Force.
• 29. First, let me clear the goal of this part of the presentation. Neither I have the golden

solution nor I will tell you about how to run your business, rather I will trigger the discussions and exchange ideas. However, let us have a look on the statistics of RNLAF flight accidents from the year 1952 to 2011.

• 30. As you can see, the rate of accidents has decreased drastically. Again, with the change
• f situation and requirement, the risk factor have been increased in all sectors, i.e. complex

mission, complex aircraft, technology, role of crews, rules and regulations, culture, society and so on. But to eliminate or reduce the risk factor limited resource is a great obstacle. Same time if question comes, i.e. Are today's safety efforts sufficient for future? The simple answer of this question will be NO. To clarify this point let us see another slide.

• 31. It says that decreased budget and re-organization also influence the overall safety
• efforts. If the ambition level and mission requirement is high and the allocated budget is

constraint it effects the overall task in terms of capacity.

• 32. Now, let us see, for the same factor how the commander/supervisors are affected. If

the commanders remain preoccupied and worried, it influences the safety efforts directly. Moreover, Forced to focus on major problems increasingly focused on delivering change and savings, risk of accepting status quo safety can play the major role.

• 33. For the same factor the working personnel level is also affected. High workload, level
• f experience, level of supervision, training time and standard and finally the motivation can

eliminate the flight safety threats in limited resources.

• 34. Finally, the findings are: today's safety measures are not sufficient for future. At the

same time, it is also clear that budget cut and re-organizations influence the safety efforts. So, not the golden solution but the focus on target commanders, identify required safety level, safety program management implementation, commitment to principle not just procedure, translate mishaps into cost, make safety personnel, communicate safety message and upgrade SOPs which we should never deviate.

• 35. Ladies and Gentlemen, as I mentioned before that Flight safety is an on-going

process, therefore, we always hunt for developing this sector through sharing of knowledge and experience. For that we always compare our state with the better one and pick up the appropriate tools for us.

• 36. As you all know, USAF is well-known and highly sound in operational matters, let us

have a look on to Flight Safety trends of USAF. it is to be mentioned that on this part of presentation I have taken reference from a presentation given by Major General Margaret Woodward, Chief of Safety Of USAF.

• 37. If you analyze the flight safety trend of USAF from the year 1952 to 2011, you can

understand how rapidly they have improved in terms of flight safety and thereby could minimize the number of fatalities. In the year 1952 total no of fatalities was 1214 and no of destroyed aircraft was 789 whereas, in the year 2011 there were only two fatalities and seven destroyed aircraft.

• 38. Now, let us see the secret of their dramatically improvement on flight safety issues.

If you look into their fighter aircraft cost and development process you can see that with the passage of time, both aircraft cost and design to production time has been increased. Here, points to be noted that not only the aircraft procurement cost but also the design development time scale needs to be increased on the basis of requirement to develop the whole sector.

• 39. Let us go back to the clues to prevent their major mishaps. Working out with the

weak hazard signals i.e. reporting has helped them to protect minor incident which may finally turn into a major mishap. USAF has also implemented pro-active safety measures which are data centric. If we break down the whole system we will find there are total three sectors.

• 40. Those are: Military Flight Operations Quality Assurance (MFOQA), and Line

Operation Safety Audit (LOSA) and Aviation Safety Action Programme (ASAP). Let us see their functions. Military Flight Operations Quality Assurance (MFOQA) is capturing and analyzing aircraft flight data to establish a base line of normal flight operations, to detect trends towards operational limit, and to detect exceeding pre-set parameters. Line Operation Safety Audit is the accumulation of observations of normal crew behavior in normal

• missions. ASAP is voluntary reporting which highlight errors and hazards to provide feedback

to commanders about risk vs mission. Ultimate objective is to promote a healthy safety

• culture. There are some examples of ASAP.
• 41. As you can see, the co-pilot shifted attention from scanning for the traffic, thereby

the lowest height was 100 ft AGL and he had to pull back the control which was a big safety

• hazard. This incident was reported by other crew member.
• 42. Again, another example will make it further clear. We often ignore what we see
• regularly. Like this slide, the fuel bouger crew was trying to communicate with the pilot of an

aircraft by placing the bouger very close to the aircraft.

• 43. Finally trend review and action committee compiles all the inputs to analyze the safety
• trend. Through the above discussion we may conclude that it is better to be Pro-active than

Re-active as of existing method applied by USAF to minimize the accident record following the formula of safety, Standards & Evaluation, Military Flight Operations Quality Assurance (MFOQA), Line Operation Safety Audit (LOSA), Aviation Safety Action Programme (ASAP), Tactics and Training.

• 44. Ladies and gentlemen, USAF challenge is to transform safety by fusing data sources

by following three key programs which already I discussed. Finally, their goal is to prevent mishaps rather than investigate.

• 45. Ladies and gentlemen, I am almost at the end of my presentation. So far I have

discussed about Civil Airlines statistics of the year 2012 where I have covered the statistics and the analysis of the crucial safety aspects for the year 2012, then I have discussed on increased Non-scheduled flight in Bangladesh, BAF Flight Safety trends for last 30 years, also BAF Flight Safety record of 2012. At last, I have shared my knowledge on Flight Safety threats in an environment of limited resources and finally Flight Safety trends of USAF. Since the

beginning of aviation arena, flight safety is an issue of top most discussion. As of now, standing in 21st century it has travelled a long way with full of difficulties and challenges

• ahead. Today, being a part of this forum, I would like to say only one slogan behind the

successful story of the glorious aviation safety history - KEEP CALM, FLY SAFE and LAND BACK SAFELY.

• 46. Thank you for your patience hearing. Now, I will be glad to answer any of your queries.