New Zealand Air Line Pilots’ Association
“Contains the most comprehensive information on the 1979 Erebus disaster. This New Zealand Air Line Pilots’ Association (NZALPA) site is dedicated to informing us all about the plane crash that took the lives of 257 passengers and crew of Air NZ flight TE901 on November 28, 1979.
Antarctic overflights were a new and exciting breakthrough in airborne tourism. Interest in the Antarctic had been particularly strong amongst the scientific community since the late 1950s, but only a small number of privileged people had experienced the wonders of the icy south.
Integral to the ability of Air New Zealand to provide the Antarctic flights was their new long-range aircraft, the McDonnell Douglas DC-10. During the 1970s, several high-fatality and high-profile DC-10 crashes meant that, when ZK-NZP went down in Antarctica, immediate suspicion was laid on the aircraft.
At the heart of much of the eventual controversy surrounding the causes of the accident were changes made to the flight plan of TE901. The plan loaded into the aircraft’s flight management computer was not the one that the flight crew had been briefed on 19 days earlier, but no one had told them.
During the course of the investigation, Air New Zealand’s Captain Gordon Vette went to extraordinary lengths to gain an understanding of, and explain to others, the sector white-out phenomenon. His research was heralded internationally as ground-breaking: it played a pivotal role in understanding the causes of the accident and, more importantly, in preventing recurrences.
My chief interest in this story stems from my great respect and regard for the Hon. Justice Peter Mahon. And he really was honorable. He led the Royal Commission of Inquiry into the Erebus disaster and was a Judge of the High Court of New Zealand. He was given 10 points of reference for his inquiries, the most significant of those being to determine whether any ‘culpable act’ had led to the disaster, be that act committed by someone on board or on the ground.
The decision to hold a Royal Commission had been announced by Attorney-General Jim McLay in early March before Ron Chippindale, the Chief Inspector of Air Accidents, had completed and released his report. Despite advice to the contrary, the New Zealand Government allowed the Chippindale report to be made public in early June. “Despite its careful catalogue of matters which might be contributing causes, it had very clearly placed the responsibility for the accident upon the aircrew.”
The “Mahon Report”, as it came to be known, is the Judge’s official summary of evidence presented to the Commission, and his assessment of culpability as established by his analysis of that evidence. Justice Mahon’s conclusions were very different from those reached by the Chief Inspector and they effectively cost him his career.
For the aviation layman, this document provided excellent explanations of a number of technical aspects of 1970s’ airline flying that sit at the core of this case. Justice Mahon, though not an aviator, went to considerable lengths to ensure he had a solid understanding of:
* The DC10’s navigational system
* The DC10’s cockpit voice recorder (CVR) and the processes involved in arriving at a transcript
* The process of planning for, and the legislation surrounding, new airline routes
* The whiteout phenomenon; and
* The alteration of the position of the McMurdo waypoint
A reading of these sections will provide anyone with a deeper understanding of the key components of evidence provided. However, it is not Justice Mahon’s thorough technical explanations that make this an extraordinary document: it is his analysis and appraisal of who did what and why, both prior to the disaster and during the Commission of Inquiry.
Justice Mahon is both fair and uncompromising in his analysis. It was a generally held view that he essentially dismissed Chippindale’s efforts but that is not accurate. He acknowledged that the Chief Inspector faced a task that was “daunting in the extreme” and that the constraints of the format under which he was required to report led to a misinterpretation of his conclusions by the general public.
Each of Justice Mahon’s opinions is framed by two primary forces: logic, and insightful analysis of the human condition. Every conclusion has at its base facts brought in evidence, but is moulded by his direct, no-holds-barred assessment of the motivations of the storytellers. The controversy of Justice Mahon’s opinions aside, his report is most notable for its groundbreaking allocation of culpability to organisational failure.”
Last year the Hon. Justice Peter T. Mahon was post-humously awarded the 2009 Jim Collins Award for his exceptional contribution to aviation safety. His controversial 1981 Royal Commission of Inquiry report into the 1979 Erebus air accident in Antarctica, cited organisational failure, ‘administration errors made by the Navigation Division’, as the primary factor of the accident, and exonerated the pilots from the blame that was apportioned to them in the 1980 Chippindale Report.
I encourage you to visit this exceptional website where you will experience firsthand the great care and attention to detail that the kaitiaki of it have taken to present the information here to all of us. A website of great substance and for which we can be extremely grateful.
