Dirgantara Air Service Flight 3130: Crime Never Pays (REPOST FROM MEDIUM)

On the 18th of November 2000, Dirgantara Air Service Flight 3130 crashes two kilometres north of the runway at Datah Dawai Airport in Indonesia. All of onboard miraculously survived the crash but are injured. What investigators looking into the crash uncover is a series of violations that ultimately caused the turboprop plane to crash.

The wreckage of Flight 3130 (Source: KNKT Indonesia)

Dirgantara Air Service Flight 3130 was a scheduled domestic flight from Datah Dawai Airport, in the province of East Sulawesi to Samarinda Temindung Airport, the provincial capital of East Sulawesi. The flight was operated by a British-made Britten Norman BN-2 Islander aircraft.

A Britten Norman BN-2 Islander aircraft (Source: Wikipedia)

The airport was owned by the government and was used to fly pioneer routes. The route is important as it is the only connection of Mahakam Ulu Regency to Samarinda.

Route of Flight 3130 from Datah Dawai Airport on the left to Samarinda on the right (Source: Google)

The pilot on this flight was Captain Abdul Hayi, a 37-year-old Indonesian national, with over 7560 flight hours, of which 3632 hours are on this type of aircraft. Only one pilot is required on this aircraft type.

In the cabin are 17 passengers, all headed for Samarinda.

At 10:51 am (local time), the flight takes off from Datah Dawai Airport and immediately, things went wrong. The aircraft barely gained any height. It barely flew over the trees at the end of the runway. The aircraft then started deviating the left of established departure path. The aircraft then turned perpendicular to the end of the runway, slammed into trees and vanished below the trees.

This was noticed by the airport’s radio operator who immediately dispatched search-and-rescue personnel. The aircraft was found 2 kilometres from the threshold of runway 02 in an inverted state. Miraculously, everyone on board the aircraft survived. To rescue the 18 people in the mangled remains of the aircraft, the rescuers removed all the seats from the aircraft.

The survivors were taken to a local hospital and the Wahab Syahrani Hospital in Samarinda to be treated for their injuries.

The Komite Nasional Keselamatan Transportasi (KNKT) or the National Transportation Safety Committee immediately began its investigation into the crash.

The investigators from the KNKT were alarmed to discover that the flight was carrying 17 passengers. The Britten Norman BN-2 could only accommodate 9 passengers at its maximum capacity. Hence, the aircraft was overloaded with almost twice the number of passengers that is usually onboard the aircraft. Interviews with survivors confirmed this. The survivors stated that the aircraft was so overloaded that seats for only two people were occupied by four people and that people were not wearing their seat belts as a result.

Throttle settings for engines (Source: KNKT)

The investigators turn their attention to the wreckage. They searched for clues that a mechanical failure had occurred. They checked the engines. The engines were operating at low power or not operating at all on impact. Had the engines failed? The investigators discovered that the engines had not been feathered on impact and that the throttles controlling the engines had been to the same setting (shut down). Hence, an engine failure most likely not happened.

The investigators then turned to the load manifests to find more clues. Shockingly, there were 2 different load manifests for the flight. The police at Tenggarong district in East Kalimantan had obtained the manifests.

The first was suspected to be made in Datah Dawai. The manifest, with a serial number of 012904, stated that there were 7 adults, one child and one infant on board the aircraft and that there was also some luggage in the cargo hold. The second one was suspected to be made in Samarinda. The manifest had its top right corner pasted over, most likely to have its serial number obscured. The manifest stated that there were 8 adults, two children and two infants aboard the aircraft and that there was no luggage in the cargo hold.

Comparison between the calculated payload in the manifests and patient records from the hospital in Samarinda revealed that the weight of the passengers had been underestimated. Further interviews with the passengers revealed that only 12 passengers had valid tickets for the flight. On addition, passengers revealed that to load the final two people on the plane, passengers who wanted to fly to Samarinda had to bribe Captain Abdul 60,000 and 1,000,000 million rupiah respectively (40 US dollars and 68 US dollars).

The investigators then decided to interview Captain Abdul. What they uncover is shocking. Captain Abdul revealed that he frequently made such deals with passengers and that they were common in the airline. Captain Abdul further revealed that pilots in the airline frequently did so to compensate for their salaries which were lower than they wanted. Captain Abdul also dropped another bombshell: that he had rotated the plane at 70 knots and not the 60 knots required. He stated that he thought the overloaded aircraft would perform better with a higher ‘rotate’ speed. This was untrue as a higher ‘rotate’ speed would imply a longer take-off run and closer proximity to terrain. As a result, the flight would have to climb steeper to climb over the trees at the end of runway 02. As a result, the speed of the aircraft would have been depleted by the time the aircraft flew over the trees.

Path taken by Flight 3130 after take-off (Source: KNKT)

Captain Abdul also revealed that he had turned the aircraft to the left after take-off to avoid trees. This was not based on the published departure route from runway 02. Captain Abdul prepared for an emergency landing. The investigators could not determine what Captain Abdul did from the point onwards. Investigators concluded that it was likely that he shut the engine down improperly in the spur of the moment. The investigators also could not find any published return-to-base procedures for aircraft experiencing issues for Datah Dawai Airport.

Looking further into the documentation of the flight, there uncover more violations. The crews of Dirgantara Air Service never filled up Flight Clearance for their operations from Samarinda. This violates Indonesian aviation law. It was also found that for pioneer flight services (like Flight 3130), the government required airlines to hire their human resources (like ticketing agents and loadmasters) but the ones hired by the company were unknowledgeable about the job. This could have also affected the safety of pioneer flight services.

The investigators also found out an issue affecting pioneer flight services. The government had subsidized these flight services so that common people can afford the tickets. This, in turn, generated a lot of demand for these flights. The number of flights provided by airlines are also regulated by the government and cannot be increased or decreased by the airlines without governmental approval. This rapidly increased the possibility of bribery as unsupervised airport staff and authorities may take bribes from passengers unwilling to wait in line.

A final question remained unanswered. Did the airline know of the unsafe practices that brought down Flight 3130? If so, why hadn’t they stopped it?

Investigators discover that the airline had sent notices that such inappropriate practices, the airline did not enforce them. This most likely led pilots into a false sense of security that they would not be caught and that such behaviour is rewarding.

In its final report, the KNKT stated that the cause of the crash was overloading, bribery at the airport as well a misconception held by Captain Abdul that ultimately doomed Flight 3130. The KNKT recommended that Dirgantara Air Service should enforce more control over ensuring that its pilots obey regulations. It also recommended that the local government make it clear to the airlines regarding its stand on hiring personnel. It also suggested that the government put more research into demand for pioneer routes and to enforce more supervision so that willful misconduct, like bribery, never happens.

The tale of Dirgantara Air Service Flight 3130 is a cautionary tale of how corruption within the aviation industry is dangerous. It also illustrates how that airlines should also enforce control on its pilots to ensure that they do not break rules for their benefit.