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Old 29th Apr 2019, 12:29
  #4572 (permalink)  
meleagertoo
 
Join Date: Mar 2018
Location: Central UK
Posts: 391
Coverage released on Apr 16th:

On Apr 11th 2019 The Aviation Herald received a full copy of the Flight Operations Manual (FOM), Revision 18B released on Nov 30th 2018, which is currently being used by Ethiopian Airlines (verified in April 2019 to be current). Although Boeing had issued an operator's bulletin on Nov 6th 2018, which was put into Emergency Airworthiness Directive 2018-23-51 dated Nov 7th 2018 requiring the stab trim runaway procedure to be incorporated into the FOM ahead of the sign off of this version of the FOM (the entire document is on file but not available for publishing), there is no trace of such an addition in the entire 699 pages of the FOM.

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It turned out, that only very cursory knowledge about the stab trim runaway procedure exists amongst the flight crew of Ethiopian Airlines even 5 months after the EAD was distributed.
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Leaving aside for now the vexed question of Boeing's engineering solutions, something few of us as pilots are really well versed in, it seems to me that the crux of the Ethiopian accident is going to centre on the chilling lines in bold above.

The Indonesian accident was in a way more understandable because of the startle factor despite the unbelieveable precursors to it on previous flights and the standards involved there (which are a completely seperate can of worms) but they should have caused global awareness of the problem very quickly. And did. Mostly.

Focus on operating procedures at Bishoftu will eventually coalesce arond the matters highlited above (if indeed they prove true) but Avherald has a pretty good reputation for sound info.
As I've asked before how can it be possible for two professional pilots on a type with a known and highly public failure mode to appear not to be aware of it's symptoms when it occurs to them? Are these guys hermits with no exposure to global media, internet or crewroom discussions? What the heck else was their 737 crewroom discussing in the months after LionAir? It doesn't seem possible pilots could be so out of such an important and contemporary loop. Or does Ethiopian really exist virtually isolated in a world of it's own?

Worse - the failure of the airline to publish Boeing's amendments and advice. That is a FUBAR of truly epic proportions - unless that sort of thing isn't regarded locally as a FUBAR, but just the way Ethiopian does things...

Worse still, if true, the apparent lack of awareness appears not restricted to the accident crew alone but is shared by many of their colleagues. Is this a cultural thing perhaps?

What this all seems to boil down to is chronic and unrecognisably bad procedures in Ops standards in not one but two airlines. The Human Factors people are going to have a field day over these 'cultural' issues here - be they company or national, which is increasingly looking like one of, if not the major player in both accidents.
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