Crash of Royal Australian Navy Sea King Helicopter and Other Incidents - Case Study Example

Military leadership Course Tutor University State Date Introduction Royal Australian Navy Sea King Helicopter crashed on the Island of Nias in Indonesia while providing humanitarian operation dubbed SUMARTA ASSIST II on 2nd April 2004 at 4 pm local time. 11 members were on board, however 2 escaped the wrath of death but 9 other defense force members lost their lives (Daley, 2007). The helicopter N16-100 was a military property of Australian government. After this accident, a commission of inquiry was set to research on the cause of the crash that led to a loss of 9 people (Thompson, 2009). The report came up with findings showing all the possible cases that might have led to the helicopter crashing. The report found gross leadership mistakes in the Naval Aviation safety system, Logistics system, ADF airworthiness system, and Aviation Training and Education. This research paper discusses the implications of poor leadership within the Australia camp that led to the error hence loss of lives (Black, 2011). Operation SUMATRA ASSIST This was the name accorded to this operation. It was involved with the Australian Defense force offering humanitarian assistance to Indonesians after an aftermath of the tsunami that hit the Northwestern coast of Sumatra on 26th December 2004 (Coles, 2011). The Accident At around 4 pm local time when the helicopter was just about to land, the helicopter developed a difference in attitude and adopted a nose down attitude before losing height and crashing with a medical team of 7 passengers and 4 crew members. The helicopter then burst into fire and was destroyed. The aircraft caught fire because of leakages and the butane cylinders that were on board illegally in the aircraft accelerated the fire. Board Scrutiny Using evidence collected from the scene of the crash and eyewitnesses, the board concluded that the crash was survivable but safety measures were deficient. So what might have gone wrong? The board of inquiry realized that there were deficiencies in seating, restraint systems, internal cabin structure, and materials (Defence, 2009). The deficiencies led to increased impact, flail, and toxic smoke, whichpresented challenges for the crew to escape. For his reason, this directly led to the death of the 7 passengers who might have escaped death. In addition to this, the board also realized that the cause of the crash was due to the mix up in the aircraft unit. The aircraft developed a separation of the fore bell crank with the pitch control linkages hence a breakdown between the pilot control inputs and tail rotor system. The board of inquiry then decided to follow up a series of maintenance errors that resulted in the mix up (Ergas, 2011). Errors in Maintenance and Organization 57 days before the accident, Squadron Sea King Detachments maintenance team made errors while conducting the inspections of the maintenance conducted. The team erred in documentation as well as in securing the fire bell crank. It was realized that the process of maintenance was full of errors, oversights, inadequate supervision, and continued habit of noncompliance with maintenance and regulations (Kinnaird, 2003). This resulted in poor communication and coordination within the shifts (watches) and handover of the shifts. It is therefore important for Squadron leaders to comply with all military aviation maintenance processes. The process of handing over the watches was also full of breakdown in communication. The leaders should learn from their counterparts and ensure that there is strict supervision and constant communication between the engineers and the supervisors. The report also indicated that the maintenance team used irrelevant Naval Aviation completion of Aircraft documentation (Mortimer, 2008). Squadron leaders must ensure that the documentation used is up to date and that it complies with the naval regulations of aviation. In addition to this, the board of inquiry noticed lapses during the management of flight. For example, the flight authorization documentation was wrong. There was also a poor application of risk management procedures mostly regarding dangerous/toxic goods from the passengers on board were doctors hence needed to carry medication (Pappas, 2009). For this reason, Squadron leaders must ensure that flight control documentation is done properly to avoid unnecessary errors. Squadron leaders must also take keen interest regarding the issue of transporting dangerous goods and their security in the aircraft since this led to toxic gases hence preventing a larger part of the passengers from escaping the fire after the crash (Rizzo, 2011). The 817 Squadron team was then scrutinized by the commission of inquiry and realized the following weaknesses in leadership. There was an increased tempo and workload in the 817 Squadron team between 2000 and 2004 resulting from Government operations (Royal Australian Navy, 2007). For this reason, this team was under intensive pressure while at work and this resulted innoncompliance. However, it was realized that consistent warnings over the quality of maintenance was given by maintenance audits, technical investigations, and safety occurrence. Ironically, these warnings were regarded as separate events hence neglected. Squadron leaders should learn a lesson from this. They must ensure that there is a systematic coordinated response in all separate incidences under good command and management (Thomson, 2011). Either the leaders must also resist heavier workload from government duties, or increase work personnel, or they take only duties, which they can handle. The increase in workload resulted in impairment of their quality of work and eventually leading to heavy losses and death of innocent people. The increase in workload and pressure from government task also led to a detrimental effect on supervision and maintenance conducted by the Squadron. Squadron leaders must be in a position in which they fully understand their responsibilities for airworthiness and avoid confusion regarding the relative roles of ADF airworthiness system authorities and agencies. This meant that Squadron leaders did not comply with the safety and airworthiness regulations. In order to avoid such incidences, current Squadron leaders must ensure that there is proper reinforcement and education regarding safety defenses. Despite the fact that the aviation logistic support was providing special demands to the ageing aircraft it was important that they offer the same to the 817 Squadron team. For this purpose, the team was incompetent for not complying with the logistics support. Current leaders of the Squadron team must ensure that they are up to date with the aviation logistics support to avoid lag cases, which contributes to risks and accidents. I therefore agree with the board, which recommended that the logistical support system improve their communication to avoid cases of Squadron detachment. The board also realized that previous reports and inquiries regarding similar incidents had not been implemented. For example, 1995 Bamaga Sea King Accident recommended that there should be changes in the passenger’s seats as passengers suffered serious injuries in their shoulders during accidents (Schank, 2011). During the 10-year period, no crashworthy and harness seats were installed in the aircraft. Current squadron leaders must ensure that they revisit past experiences and come up with improvements. They must also ensure that they comply with recommendations made by previous inquiry and implement them. Forensic studies indicated that more passengers would survive flail during the accidents had the crashworthy seats been installed in the Sea King N16-100. Although naval aviation relies upon trust between the maintenance team and the naval aviation team, the board of inquiry concluded that such trusting environment led to noncompliance with the regulations. For this reason, managers and supervisors must ensure that they hold healthy wariness at all levels and must ensure regular testing of the supervision before giving a final hand over. The commission of inquiry argued that such trusting incidences resulted into the lapse of staff and incompetence. Squadron leaders must also ensure that passengers do not carry prohibited and dangerous goods while in transit. Sea King N16-100 was carrying butane cylinders belonging to a civilian aid worker. The presence of the butane cylinder intensified the explosion experienced in the aircraft especially after the impact (Tange, 2003). Squadron leaders are under obligation to change their culture of leadership and operations in order to avoid such incidences. This is because the commander in charge focused so much on culture but forgot to analyze the discrete symptoms that resulted from that kind of leadership. According to the report, the contingency loading within the environment where there was enough time for planning and preparing any aero medical evacuation role was not appropriate hence this demonstrates poor planning. Squadron leaders in this circumstance must ensure adequate planning during mission analysis. In addition to this, the leadership in charge of SUMARTA ASSIST I made a profile, which they did not review while undertaking the second operation of SUMATRA II hence, showing incompetence considering that this was a foreign mission with high risks (Royal Australian Navy, Defence Policy-Making: A Close-Up View, 1950–1980, 2008). The review of the mission profile for both the operations was treated as a requirement instead of treating it as a safety measure. Conclusion Squadron 187 suffered various leadership challenges that led to the poor maintenance of Sea King N16-100 leading to its crash in Indonesia. The Squadron team confessed of increased overload in their operations and this resulted to lack of proper supervision. This kind of incompetency and faulty operations led to the crash of the aircraft. It is also evident that the maintenance team had not implemented various recommendations that required installation of crashworthy seats in the Sea King crafts. Bibliography Black, R. (2011). Review of the Defence Accountability Framework. Canberra: Department of Defence. Coles, J. (2011). Collins Class Sustainment Review. Canberra: Department of Defence. Daley, P. (2007). The fatal journey of Shark 02. The Bulletin, pp. 22–29. Defence, D. o. (2009). Defending Australia in the Asia Pacific Century: Force 2030. Canberra: Defence White Paper. Ergas, H. a. (2011). ‘More Guns Without Less Butter: Improving Australian Defence Efficiency. Agenda, 18(3). Kinnaird, M. (2003). Defence Procurement Review. Canberra: Department of Defence. Mortimer, D. (2008). 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