Airblue Flight 202
|Date||28 July 2010|
|Summary||Controlled flight into terrain aggravated by inclement weather, pilot error.|
Margalla Hills, Pakistan |
|Aircraft type||Airbus A321-231|
|IATA flight No.||PA202|
|ICAO flight No.||ABQ202|
|Call sign||AIRBLUE 202|
|Flight origin||Jinnah International Airport, Karachi, Pakistan|
|Destination||Benazir Bhutto International Airport, Islamabad, Pakistan|
Airblue Flight 202 was a scheduled domestic passenger flight which crashed on 28 July 2010 near Islamabad, the capital of Pakistan, killing all 146 passengers and six crew on board. It is the deadliest air accident to occur in Pakistan to date. The aircraft, an Airblue operated Airbus A321-231 narrow-body jet airliner, crashed in the Margalla Hills north of Islamabad during a flight from Karachi's Jinnah International Airport to Benazir Bhutto International Airport. Air traffic controllers lost contact with the flight crew during its attempt to land in dense fog and heavy monsoon rain.
The accident was the first fatal crash involving an Airbus A321, a long variant of the Airbus A320 family of short to medium range airliners. Based in Islamabad, Airblue is Pakistan's second largest airline, with over 30% share of the domestic market. At the time of the accident the airline operated seven aircraft, all in the A320 family.
The aircraft that crashed was an Airbus A321-231, registered AP-BJB, The aircraft was built in 2000, and had a manufacturer serial number of 1218. This was the first fatal crash for the A321, and the second hull-loss of the type. The aircraft had originally been delivered to Aero Lloyd and used by Aero Flight before being taken up by Airblue in 2006. It had accumulated over 34,000 flight hours in some 13,500 flights. The aircraft was previously struck by lightning on 30 December 2008.
The Captain of Flight 202, 61-year-old Pervez Iqbal Chaudhry, had 25,500 hours of flying experience, with 1,000 hours on the A320 aircraft. The 34-year-old First Officer (Sqn Ldr) Muntajib Ahmed, a former F-16 Pakistan Air Force fighter pilot, had almost 2,000 hours of flying experience and only for the short time on the A320 aircraft.
The flight left Karachi at 07:41 local time (02:41 UTC). Flight controllers at Benazir Bhutto International Airport lost contact with the aircraft at 09:41 local time (04:41 UTC). Weather conditions at the time were marginal, and the captain of a China Southern airliner had diverted to an alternate airport thirty minutes earlier.
The aircraft approached Islamabad from the southeast, following a procedure that required it to fly toward the airport until making visual contact. It was then to have flown around the airport to the east and north, keeping within a distance of 5 nmi (9.3 km), until lining up with runway 12, which faces toward the southeast. The aircraft crashed in the mountains outside the 5 nmi (9.3 km) radius, approximately 8 nmi (15 km) north of the airport, facing almost due west, before it could line up with runway 12 for final approach.
While the BBC reported that officials stated that "there was nothing in conversations between the pilot and the Islamabad control tower that suggests anything was wrong", Multiple EGPWS "TERRAIN AHEAD" warnings were recorded on the Cockpit Voice Recorder starting 40 seconds before the crash. The first officer was also heard requesting to the captain "Sir turn left, Pull Up Sir. Sir pull Up."
The pilots did not send any emergency signals prior to the crash. Pakistani Interior Minister Rehman Malik stated that the plane was at 2,600 feet (790 m) as it approached Islamabad but went back up to 3,000 feet (910 m) before eventually crashing. The altitude of 2,600 feet (790 m) was above the safe minimum descent altitude (2,510 feet (770 m) above sea level, or 852 feet (260 m) above ground level) had the aircraft remained within the 5 nmi (9.3 km) radius of the airport.
One witness on the ground, who was out walking, stated that "the plane had lost balance, and then we saw it going down". Others described the plane as being lower than it should have been. "I wondered why the plane wasn't flying higher as it was flying towards the hill", one stated. "Then within three or four minutes I heard a loud explosion". Another said that "it was raining. I saw the plane flying very low from the window of my office". Imran Abbasi told The New York Times that he "could tell it was trouble because it stayed so low even though the mountains were up ahead". He stated that the jet was "flying as low as a four-story building". It was reported that Abbasi said that "as the aircraft started to turn, the right side of its front banged into the highest mountain, emitting an instant billow of blue fire and black smoke".
The plane was found near Daman-e-Koh viewing point in the Margalla Hills outside Islamabad. The Los Angeles Times reported that "television footage of the crash site showed smoke and burning debris strewn in a swath cutting through the forest. Rescue helicopters hovered overhead. Fire was visible, and smoke was blowing up from the scene."
The weather conditions nineteen minutes after the accident, as detailed by the 05:00 UTC METAR (aviation routine weather observation message) report for Benazir Bhutto International Airport, were as follows: Wind from 90° (east) at 18 knots (33 km/h). Visibility 3.5 kilometres (2.2 mi), rain, scattered clouds at 1,000 feet (300 m), few clouds at 3,000 feet (910 m) overcast at 10,000 feet (3,000 m). Temperature 25 °C, dewpoint 24 °C. QNH 1006.9 hPa.A
Passengers and crew
There were no survivors. Pakistani footballer Misha Dawood, 19, of Diya Women Football Club (DWFC), Karachi, and former national athlete Zafar Saleem, who was director-general of the Sindh Workers Welfare Board, were among those killed in the crash.
Of the passengers, 110 were men, 29 were women, 5 were children, and 2 were infants. One active duty Captain of Pakistan Army along with six members of the Youth Parliament of Pakistan were on board, as were three off duty air hostesses, and four foreign nationals.
Nationalities of passengers
A local police official stated that he had reports "that the plane fell into the Margalla Hills. There is smoke, but we have not been able to reach there. It is surrounded by the hills and there is no road access". An army helicopter arrived to survey the crash site at 10:30 local time (04:30 UTC) but was not able to land. All 152 passengers have been confirmed dead. All hospitals in Islamabad were declared in a state of emergency.
One person present at the scene of the crash stated that the passengers "are badly mutilated and burnt ... and there are two women among the dead". He told journalists that "a good number of rescue workers have reached the site. Other people have reached here on their own. The plane is totally destroyed. The pieces and parts scattered over a large distance. Some parts of the plane are still burning. Some bushes have been burnt." It was reported that rescuers at the crash site were "digging through the rubble with their bare hands." A senior city government official stated that the rescue operation was "very difficult ... because of the rain. Most of the bodies are charred. We're sending body-bags via helicopters."
It was reported, however, that the rescue operation was "chaotic". BBC journalist Zeesha Zafar reported that "there were fewer rescue workers there than one would have expected. A majority of them were members of the anti-terrorism police. Most of them just stood around, gazing at the burning debris, and looking as though there was not much that they could do." He stated that a police officer threatened to baton charge rescuers if they did not "move quickly". Zafar reported that "just when the rescuers were shuffling to get to work, a policeman in plain clothes announced that an army helicopter was coming in to pour water on the fire, and that everyone should get out of the way. The work stopped. The helicopter came, circled on the spot a couple of times, and went away. No water." Zafar went on that it "was distinctly obvious that there was no co-ordination between the workers of different departments such as the police, the rescue department, the Capital Development Authority and the military ... Rescuers operated in a chaotic manner, scouring through the debris that was not on fire ... During the two hours that I stayed at the scene, I saw rescuers collect three separate loads of body parts which they tied up in shrouds. There was no telling how many people they belonged to."
A statement on Airblue's website stated that "Airblue, with great sadness, announces the loss of flight ED 202 inbound from Karachi to Islamabad. The flight crashed during poor weather and thick fog. We regret the loss of life and are investigating the exact circumstances of this tragedy. This will be presented as soon as possible." The statement continued that "our hearts go out to the families and loved ones of the passengers and crew." The compensation estimation process for the victims by Airblue's insurer began on 30 July 2010, with initial estimates of Rs 1,000,000 (US$11,169) per victim.
Both the Pakistani President Asif Ali Zardari and Prime Minister Yousaf Raza Gillani sent condolences to the family of those who died in the accident. The Pakistani government declared 29 July 2010 would be a national day of mourning and announced compensation of Rs 500,000 ($5,847) to the family of every victim. U.S. President Barack Obama issued a statement confirming that two Americans had been on the flight and expressing condolences and stated that "our thoughts and prayers go out to all of those touched by this horrible accident". The Airblue management decided that a monument would be built with the names of the victims inscribed onto it to honor the dead.
The Civil Aviation Authority immediately launched an investigation into the accident. Airbus stated that they would provide full technical assistance to Pakistani authorities. A six-member Airbus team, headed by Nicolas Bardou, the company's director of flight safety, arrived in Islamabad on 29 July 2010.
The aircraft's flight recorders were located on 31 July, when Junaid Ameen, the director-general of the Pakistan Civil Aviation Authority, told AFP that "the investigating committee found the black box from the Margalla Hills this morning ... the black box was found from the bulk of the wreckage of the crashed plane." He stated that the box would be examined by "foreign experts" in Germany or France as Pakistan does not possess the equipment to decode the flight recorders. He also stated that the process of extracting information may take six months to a year. The Pakistani authorities decided to send the CVR and FDR to the Bureau d'Enquêtes et d'Analyses pour la Sécurité de l'Aviation Civile (BEA) in France.
The report issued by Pakistan's Civil Aviation Authority in November 2011 cited a lack of professionalism in the cockpit crew along with poor weather as primary factors in the crash. In particular, the report noted that the captain ignored or did not properly respond to a multitude of Air Traffic Control directives and automated terrain warning systems. The report also claimed that the first officer passively accepted the captain's actions, after the captain on multiple occasions took a "harsh, snobbish and contrary" tone with the first officer and "berated" him.
The report concluded that the crash was a Controlled Flight into Terrain accident, in which aircrew failed to display superior judgment and professional skills in a self-created unsafe environment. In their pursuit to land in inclement weather, they committed serious violations of procedures and breaches of flying discipline, which put the aircraft in an unsafe condition over dangerous terrain at low altitude.
Representatives of family members of passengers on the flight questioned the validity of the report and the qualifications of those who carried out the investigation.
Sequence of events leading to the crash
The Pakistan Civil Aviation Authority (PCAA) issued the final report in November 2011. It covered the key events that lead to the crash.
The aircraft took off at 02:52 UTC. During the initial climb, the Captain tested the knowledge of the First Officer, and used harsh words in snobbish tones while speaking to him. This was very contrary to Airblue's procedures. The lecture continued for about one hour, with only brief intervals. After the humiliating session, the First Officer remained mostly silent throughout the rest of the flight, likely from a loss of self esteem and confidence. Subsequently, the First Officer did not challenge the Captain over any of his errors or violations.
While Flight 202 was descending to Islamabad, the Captain decided to change the instrument landing approach to a visual circling approach. The Captain checked the weather apprehensively, and asked the First Officer to feed unauthorized 04 waypoints in the FMS. The First Officer did not challenge the Captain for his incorrect actions (which may have been caused by the "lecturing session" earlier). The Captain then briefed the First Officer that he would turn the aircraft in the direction of Runway 30, later to abeam 5 miles from the runway and then land.
However, this is contrary to the procedures in Islamabad for a visual approach. When a visual approach is executed, the plane automatically strings a final leg extending the runway centerline. It starts at a waypoint labelled "RX" (Extended Center line) created 5 NM from the runway threshold and ends at the runway threshold.
The Captain then requested a right hand downwind visual approach to Runway 12 (the request again being contrary to established procedures at Islamabad Airport), but this was not agreed to by the Radar due to procedural limitations. The Captain became worried about bad weather and low clouds on the left hand downwind. The aircraft then started its descent. The First Officer then repeated the request, but it wasn't agreed on by the control tower, and retained the decision for the crew to make a left downwind. Once again the Captain requested if the right downwind was available, but this still wasn't agreed on by the control tower.
The Captain wanted to descend to 2,000 ft, but the First Officer reminded him that the Minimum Descent Altitude (MDA) was 2,500 ft, indicating the possible intentions of the Captain. However, later on, the plane descended through 2,300 ft, thus violating the MDA of 2,500 ft. After break-off from ILS approach, the Captain ignored the tower controller’s suggestion to fly a bad weather circuit by saying “let him say whatever he wants to say”. The CVR recording and flight simulation show that the Captain probably decided to fly a managed approach, unbeknownst to the ATS.
The crew commanded a left turn to 300° through the autopilot. This could be done by rotating the heading knob of the aircraft to the heading that the crew wanted and subsequently pulling the knob, which would cause the plane to turn. However, because the crew forgot to pull the knob, the plane didn't turn. A few seconds later, the first "terrain ahead" warning sounded. The First Officer told the captain "Sir, higher ground has reached, sir, there is a terrain ahead, sir turn left”. By now the Captain had become very jittery in his verbal communication and displayed frustration, confusion and anxiety resulting in further deterioration in his behaviour.
Later on the Captain became confused due to several issues, including the tower being asked frequently if the aircraft was in visual approach, the imminent collision with terrain, and the plane not turning on the heading it had been programmed to. The pilots were unsure of their geographical position and did not seek radar help. The consequent loss of situational awareness caused the aircraft to go astray. In an attempt to turn the aircraft to the left, the Captain was setting the heading bug on reduced headings, but not pulling the HDG knob. Since the aircraft was in the NAV mode, the Captain was not performing the appropriate actions to turn the aircraft to the left. The "terrain ahead, pull up!" warning then sounded several times.
The aircraft ended up in a dangerous situation mostly because of unprofessional handling by the Captain. Since the desired initiative of the First Officer had been curbed and a communication barrier had already been created by the Captain, the First Officer failed to intervene and take over the controls to pull the aircraft out of danger and display the required Crew Resources Management (CRM) skills.
During the last few seconds, the aircraft climbed to 3,090 feet. The Captain put in 52 degrees of bank to turn the aircraft, and also made some nose down inputs. Therefore, the aircraft pitched down, speed increased and auto thrust commanded the engines to spool down to keep airspeed on the target speed. The aircraft started to descend at a high rate. Unfortunately in his panic, the Captain continued to move the heading knob without actually looking at it, but failed to pull the knob to activate it. When he did activate it, the aircraft turned towards the heading knob that had been rotated too far, to 25 degrees, and stayed on that course until end of recording. At 04:40:49 the Captain said to the First Officer "Why the aircraft is not turning left?" The aircraft then slammed into Margala Hills and exploded. The First Officer's last words could be heard saying to the Captain "Sir we are going down! Sir we are going do—".
- Accidents and incidents involving the Airbus A320 family
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