Thank you Deputy Commissioner Billet and distinguished guests. I am pleased to be with you today representing the National Transportation Safety Board and am grateful to His Honor, Mayor Guiliani, for the invitation to come speak to such a distinguished audience.
Last year marked the 30th anniversary of the Safety Board and I take pride in leading what many consider to be one of the finest transportation investigative bodies in the world. Over the past 30 years, in cooperation with other organizations in the United States and abroad, the Safety Board has raised the level of national and international transportation safety. It has done so by improving and standardizing the investigative process in all areas of transportation, and has served as a model for other nations that have established similar agencies.
As Thomas Jefferson, America’s third president and one of its founding fathers once said, "The care of human life and happiness is the first and only legitimate object of good government." I believe it is this simple phrase that describes the mission and goals of the National Transportation Safety Board.
As you may know, the Safety Board is an independent agency of the United States government whose mission, since its creation in 1967, has been to determine the "probable cause" of accidents and to make recommendations to improve transportation safety and prevent future accidents. Over the years, our Congress has recognized the value of the agency, first establishing its primacy over investigations conducted by other Federal agencies and then broadening its jurisdiction for accidents in all forms of transportation.
The independence of the Safety Board and its clear mandate to conduct in-depth investigations, draw conclusions from its findings, and make recommendations to improve safety, without bias or undue influence from industry and other government agencies, are essential to maintaining the safety of the traveling public. It is not unusual for the Safety Board to address safety issues that are controversial or that may be critical of government or industry standards or operations.
It is clear that transportation in general and aviation in particular is becoming an increasingly international industry, with carriers operating globally, aircraft components being built by many countries, and with citizens of many nations aboard every flight. The International Air Transport Association has estimated that 1997 saw an 8 percent increase in passenger traffic worldwide, to almost one and a half billion passengers. More than 300 foreign carriers are licensed by our Department of Transportation to fly into the United States.
Increased traffic almost inevitably leads to increased activity by my agency. Just in the last year, the Safety Board has participated on-scene in 8 foreign accident investigations, and offered the services of its laboratory in 25 foreign accidents. We also provided technical support for scores of other investigations by foreign authorities in compliance with the Convention on International Civil Aviation.
The SilkAir Boeing 737 accident in December is one of the latest involving close coordination between my agency and a foreign government in accordance with international protocols. We sent 2 investigators to Indonesia, one of whom served as the U.S. accredited representative, and the Indonesians brought both flight recorders to our Washington laboratories. Singapore sent investigators to the scene and to our laboratories because SilkAir is a Singapore airline. Further, Australia sent investigators to the scene and to our labs as part of an agreement to provide technical support to Indonesia.
The 737 is the world’s most widely used airliner, with approximately 3,000 worldwide, almost half of them operating in this country. It is imperative that any airworthiness concerns brought out in an investigation be dealt with immediately and on an international level. The U.S. has a clear obligation to verify the airworthiness of aircraft manufactured in this country just as similar information on aircraft manufactured in other parts of the world could affect the safety of millions of travelers. This demonstrates the importance of multinational cooperation in accident investigations.
International economic concerns also bring increasing pressure to find out what went wrong in an accident and, if an airworthiness issue is involved, to fix it immediately. The U.S. Department of Transportation estimates that civilian aircraft, engines and parts provided $26 billion toward our balance of payments in international trade in 1995, the latest figures available. No manufacturer – indeed, no manufacturing country – wants a repeat of the Comet experience in the 1950s, when the world’s first commercial jet passenger airliner suffered a series of baffling crashes. By the time the problem was found and corrected, confidence in the aircraft had disappeared, the manufacturing country had lost its brief leadership in jet transportation, and other jet models were poised to garner the lion’s share of world airline orders.
In light of these economic and safety issues, it is necessary to keep in mind the dual nature of the Safety Board’s mission. First, of course, is to address the enormous safety and economic implications of a significant airline accident. Another issue, however, is the emotional dimension of such a tragedy. The plight of family members who have lost someone in an air disaster has increasingly become the focus of the world’s media. The United States Congress and President Clinton have agreed that this attention is both necessary and appropriate and have propelled my agency into the middle of the issue.
For 30 years, the Safety Board’s primary mandate has been, and continues to be, the investigation of transportation accidents. In October 1996, Congress passed and President Clinton signed the Aviation Disaster Family Assistance Act of 1996, giving the Board the additional responsibility of aiding the families of victims of aircraft accidents occurring in U.S. territory.
What brought about this change? For decades, following major aviation crashes in the United States, the unpleasant duty of notifying next of kin, making arrangements for transporting family members to a location near the accident site, and returning victims’ remains has been the responsibility of the air carrier. The local community responded with necessary emergency services and were sometimes supplemented by individual and group volunteers providing services such as grief counseling and food services.
I have been to the scenes of 4 major airline accidents in which there were no survivors: USAir flight 427, which killed 132 in Aliquippa, Pennsylvania; American Eagle flight 4187, which killed 68 in Roselawn, Indiana; ValuJet flight 592, in which all 110 occupants perished in the Everglades; and TWA flight 800, which exploded off the coast of Long Island, killing all 230 aboard.
In January 1995, when I chaired the Safety Board’s public hearing on the Aliquippa crash, I met with the victims’ family members and became convinced that something must be done to address the concerns they expressed to me.
For those of you who have been involved with a major aircraft crash, I do not need to tell you that, historically, the affected airline’s response frequently lacked organization, coordination, and far too often, compassion. Based on Congressional testimony and other forums, we’ve heard numerous horror stories -- constant busy signals from the airline’s 800 accident information number; misidentified remains; personal effects being mishandled; unidentified remains not handled with dignity, including mass burials without informing families; and the use of confidential information obtained during this grief process against families in court.
I think we can all agree that this type of treatment can no longer be tolerated. The world has changed and all of us involved in the events following major accidents have to change with it. For instance, the recent SilkAir accident in Sumatra and the turbulence accident over the Pacific Ocean involving United Airlines were both major international media events. Family members of victims, not just in the United States, are demanding more accountability in the aftermath of accidents such as these. Their five major concerns are in the areas of initial notification of the accident, recovery and identification of victims, disposition of unidentifiable remains, return of personal effects, and access to investigative information.
These concerns are shared by family members of victims of accidents that occur in the United States, Africa or Asia – it is a common human need that goes beyond international borders. And, an additional concern in our increasingly international aviation system is the need for sensitivity to many religions, cultures and languages.
Following that meeting with the Pittsburgh families, I initiated a meeting with the Board of the Air Transport Association, expressing my concern about the way family members are treated following major accidents and asking that they develop a better way to handle the situation. I was sorry to see in the following months that the industry was unable to satisfactorily respond to that request. Therefore, at my request, Mr. Peter Goelz of my staff became – at least initially – a one-man family affairs office. He singlehandedly dealt with the many issues that arose with the families at ValuJet and then at TWA flight 800.
Finally, particularly following the ValuJet and TWA accidents, legislation was passed. This was a case where the lack of action on the part of private industry led to government intervention. This was not our preferred course, but I think Congress and the President acted responsibly in assigning this task to someone, and I believe they assigned it to us because of the Safety Board’s long and respected history at crash sites as the eyes and ears of the American people.
Our family assistance plan has been used four times since passage of the law:
• United Express accident in Quincy, Illinois – 14 fatalities.
• Comair accident in Monroe, Michigan – 29 fatalities.
• KAL 801 in Guam – 228 fatalities
• Scenic Airlines in Montrose, Colorado – 9 fatalities.
Our new Office of Family Assistance fills the void that I previously mentioned - as a coordinator to integrate the major resources of the federal government and other organizations to support the efforts of the local and state government and the airline to meet the needs of aviation disaster victims and their families. Family counseling, victim identification and forensic services, communicating with foreign governments, and translation services, are just a few of the areas in which the federal government can help local authorities and the airlines deal more effectively with a major aviation disaster.
Thanks to memoranda of understanding with six cabinet level agencies, the resources of the entire U.S. government have been made available to supplement local responders. These resources included a fully-equipped mobile morgue. In nearly every city and town in this country, the local coroner or medical examiner would be overwhelmed if a fully loaded airliner crashed. The Board sees its duty as not taking over, but rather as integrating federal services and support into the local response.
As many of you know, Congress recently passed legislation amending the Aviation Disaster Family Assistance Act of 1996 to require foreign carriers flying in or out of the United States to file family assistance plans and fulfill the same family support requirements as required by their domestic counterparts. This disparity in the 1996 legislation was brought to light and corrected as a result of the Board’s experiences at the August 1997 crash of Korean Air Flight 801 on the island of Guam.
At the time of the accident, Korean Air was not required to file a family assistance plan with the United States government and the airline’s management was not aware of the Board’s new responsibilities. In addition, when the 747 crashed on Guam, killing more than 200 persons, KAL did not have a plan of its own to support the approximately 500 family members who immediately came to the island. It took several days for Board family affairs personnel to coordinate with the airline and the local government in the establishment of a more organized family support structure.
Nevertheless, I believe that, once its family assistance effort was established, Korean Air did a commendable job for the families. Virtually everything was thought of, from installing phones in the family center – so that relatives could call back to Korea free of charge – to providing free clothing and toiletries to the families during their stay on Guam. The airline also provided free transportation and lodging for the families.
Consistent with our responsibilities and our belief that keeping the families informed is critical, the NTSB conducted daily briefings not only on the investigative process but also on the grueling task of recovering bodies and making positive identifications. The crash occurred during typhoon season and weather conditions were horrendous, hindering recovery efforts. Because the airline was unable to provide Korean interpreters for us, we relied on Korean-American residents of Guam, who volunteered their services. I mention this problem as a good example of the kinds of issues that arise at accident scenes that can be avoided if planned for.
This leads to an important issue. Not only was KAL’s response hampered by its lack of knowledge of the NTSB’s family assistance program, I am confident that any emergency plan it had on hand would have been enhanced had it been submitted to the Board for review, as is now required.
As you may be aware, the NTSB does not have the ability to reject an airline’s plan. We do, however, have the right to comment on any plan, offering suggestions based on our years of accident response and our recent experiences with family assistance programs. In short, we function as a form of institutional memory for the airline industry, able to point out past failures and successes. Immediately after the passage of the 1996 Act, the NTSB worked closely with U.S. airlines and their representatives in Washington. The development of our response plan, along with the airlines emergency protocols, was worked out in close cooperation between the federal government and private industry. I am here today to offer the same cooperation with the foreign carriers, and urge all of you to discuss with your nation’s airlines the importance of working closely with the NTSB on this issue.
The Department of Transportation has recently issued a letter to all foreign carriers having authority to serve the United States reminding them of the passage of the Act and of what their responsibilities are under that law. Those plans are due in June of this year and will be reviewed carefully by our staff. After the domestic airlines filed their plans last year, the Department issued a notice advising them that if the assurances made in those plans were not fulfilled because of neglect or bad faith the United States Government would take enforcement action against the carrier. I have every reason to believe the Department of Transportation will issue a similar advisory to the foreign carriers, a notice I hope they all take seriously.
At this point, allow me to give you some specifics about the NTSB’s family assistance plan. Our new office is composed of seven individuals, all of whom have experience in some aspect of our response. One person is a forensic anthropologist, skilled in identifying individuals by extraordinary means. Another is former manager at a major U.S. airline, familiar with the workings of the industry with which we must have close and mutual cooperation. Yet another is a certified mental health professional with years of experience in mass disasters. The senior staff member of the operation is a former U.S. Army Colonel who operated the military’s Casualty Affairs Office and who is responsible for creating our internal response plan.
I have with me today a few of our staff, including our agency’s Managing Director, the aforementioned Mr. Peter Goelz. With him is Mr. Jamie Finch, Director of our Office of Government, Public and Family Affairs and his Special Counsel, Mr. Matthew Furman, who has been on scene at all four accidents since the passage of the Act.
As I mentioned, our family affairs operation is designed to harness the assets and abilities of the federal government. We in this country, however, operate on a political system known as Federalism, which, in short, ensures that the states’ rights are not unduly infringed upon by the national government. Therefore, when we arrive on scene we are always careful to work in cooperation with the local medical examiner or coroner, whose responsibility it is to recover and identify victims. Nevertheless, I firmly believe no responsible local official will reject our offers of assistance, particularly given the track record we have already established.
I focus on the recovery and identification of remains specifically because every family member will tell you that in the immediate aftermath of a crash there is no greater interest for those who have lost a loved one. The NTSB fully recognizes that the family affairs efforts must be focused on the quick and accurate identification of remains. We can bring to the scene a fully equipped mobile morgue and the staff required to operate it. The Department of Health and Human Services operates the National Disaster Medical System and their Disaster Mortuary or DMORT teams are full partners with us in our response.
If conventional means of identification are not adequate, the Board has access to the Armed Forces Institute of Pathology, the world’s leading DNA laboratory. In the case of the Korean Air crash, in which there were more than one hundred unidentified victims, the Korean government and the NTSB worked together on the DNA analysis.
In light of our ever-present concerns about terrorism or sabotage, it is important to note that the 1996 Act requires the NTSB to conduct family affairs activities after a crash, "regardless of its cause." Therefore, in the unfortunate circumstance of an airliner crashing due to some criminal act, the NTSB would, in theory, still play a role with family assistance at the scene. The reality is that under the terms of our agreement with the Department of Justice and the Federal Bureau of Investigation, the FBI would take over much of the duties we normally have at a crash scene.
As you might imagine, this and a host of other scenarios pose unique challenges, particularly for an agency with fewer than 400 employees. The only way in which the NTSB has enjoyed its 30-year run of success is by working closely with all affected parties, and coordinating our activities to take advantage of outside resources.
In keeping with this commitment, I would like to let you know that our senior family affairs staff can be made available to your government to assist in setting up a family affairs response should a commercial air disaster take place in your country. We view our efforts as a partnership and if we can be of assistance, we would be happy to help.
In an effort to continue our tradition and apply it to new challenges, the National Transportation Safety Board, on September 28 and 29, will host an international symposium in Arlington, Virginia for industry, government and community officials to promote a better understanding of the federal government’s role with respect to families at a transportation disaster and to allow individuals and organizations that might have to respond in the event of such an accident to discuss experiences and learn new techniques in disaster resource management. I urge all of you to attend what will be the first international gathering of this kind ever conducted.
Globally, all of our citizens board airplanes, buses, ships and trains in pursuit of recreation and business. It is our mission and duty to maintain a constant and vigilant effort to keep transportation safe for all of the world’s travelers and ensure that in the wake of a tragedy, compassionate and humane treatment is given to those who need it the most. This task will be much easier if we work together to achieve this end.
Thank you and I will be happy to take questions.
Jim Hall's Speeches