MH17: a darker truth
The Malaysia 17 story has been told. But beneath the knotted narratives of the accepted version of events, well woven in the three years since the Boeing was brought into an afternoon cornfield in Ukraine, lies a simpler, darker truth.
This will be uncomfortable reading, but it was a preventable tragedy.
As industry experts, we’ve comforted ourselves knowing that “Nobody considered that civil aircraft, at cruising altitude, were at risk” (Dutch Safety Board report). When fingers were pointed at Malaysia Airlines for overflying a war zone, we were quick to tell the public “Not fair. Everybody else did as well”. We were all apparently operating under the same misguided reassurance that this was a war going on underneath the airways, and that cruising at 33,000 over the top of it would be just fine. As an airline pilot at the time, I did the same as everyone else using the eastern Ukraine routes, and monitored the conflict beneath us with interest on each flight, but without concern.
But what if we could have known — what if the risk information was actually there, but for some reason we weren’t seeing it?
Well, it was.
International aviation uses a simple system to tell pilots essential flight information: NOTAMS. Notices to Airmen. An average 3 hour flight will have 20 pages of them, and they look like this:
You might have spotted that they look a little coded. You might think that’s because computers process this information. Wrong, unfortunately. This is a format primarily intended to be read by humans — pilots — and it’s awful.
We can work with the date/time groups, and the abbreviations. CLSD for Closed isn’t so bad. RWY for Runway isn’t too hard on the brain. But let’s look at this one.
Reading this, my eyes glaze over.
On a routine post-Soviet eastern block overflight, I will see tens, maybe hundred of Tempo Restricted Areas in my 20, 30, maybe 50 page NOTAM Briefing. Russia is very fond of them, as are many Eastern European countries. I don’t plot the coordinates of them, and I trust that Air Traffic Control will keep me out of anywhere I shouldn’t be.
I would discard it with a glance and move to the next one.
This notice was on board MH17. This was the warning from the Ukraine Authorities that something was going on that the MH17 crew should know about. It was published on the Monday, three days before MH17 was shot down, and it was published only because on that Monday at 9am, an aircraft at FL210 (21,000 feet) had been shot down.
To the pilot, to the dispatcher, and to the crew of MH17 it’s indecipherable. It looks the same as every other routine TRA.
What if, instead, the Authorities had simply written what they meant?
Because that’s the message it meant to convey. That is why it was written. And no airline, pilot, or dispatcher would read this and plan a flight over the eastern part of Ukraine. Including Malaysia Airlines, and including Eugene Leong, who was flying MH17 when the Buk missile exploded 70 feet from his window.
But there’s a twist. The core problem of the Notam system is not language. The core problem is that we rely on a single source for critical flight information and analysis. The State.
So, can the state be relied upon to provide that information? Can the state be trusted? In the case of Malaysian 17, it seems not. The vague language may or may not have been deliberate, but there was nobody else to provide the check and balance.
In many cases, states flagrantly disregard the basic principle of the Notam system. A Notam is clearly defined as “information concerning the establishment, condition or change in any aeronautical facility, service, procedure or hazard, the timely knowledge of which is essential”.
Almost all states are guilty of ignoring the word essential. The vast majority of Notams now in the system are anything but. Many are completely unreadable by humans. Some of the garbage in the system has to be seen to be believed. Thank you, Australia, for this …
Remember, this is meant to be read by humans.
Worse still, states routinely omit information, or hijack the system. Greece and Turkey use the Notam system to score political points, endlessly discussing boundary disputes. Deeply troubled states like Libya, Syria, Iraq, Somalia and Yemen cannot be trusted to provide essential information. For others, like Egypt, protecting tourism is consistently higher priority than publishing safety of flight information.
Is any country, in fact, viewing the situation with the best interests of the pilot at heart? No. Higher priorities are always politics, state interests, navigation fees, tourism revenue, legal protection, and bureaucracy. Fixing the problem isn’t in any state’s interest (though occasionally they do pretend to be doing something about it).
A State is ultimately a business with its own interests. In the same way we don’t trust Coca-Cola to carry out sugar research, we should also be skeptical about information that comes from only one state source (known as the International Notam Office).
So, on that Monday afternoon in Kiev, when a couple of officials from the Ukrainian State Air Traffic Services Enterprise sat down to write Notam A1492/14, many interests lay ahead of providing a clear picture to the pilots entering their airspace. Of these, even if it was just bureaucracy that dictated the nebulous wording and not something more troubling like overflight revenue, it was a state decision that robbed the MH17 crew of the opportunity to make an informed choice about their route of flight.
Ultimately, it was a decision that cost two hundred and ninety eight people their lives.