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Nearly 16 years ago, Caroline Southcott got up to go to the toilet on a flight from Singapore to Perth but as she was returning to her seat, she suffered severe injuries that continue to impact her to this day.
Caroline says she still has small fragments of plastic working their way out of her forehead — a reminder of the extreme trauma her body went through as it hit the overhead bins.
Caroline and her husband Bruce were on the ill-fated Qantas flight 72 that experienced an emergency over the Indian Ocean in October 2008.
It was not unexpected turbulence that threw Caroline about the cabin: investigators would eventually find the Airbus A330-303 was put into two nosedives after a faulty part fed the flight control computers incorrect data.
The cabin crew had just finished serving lunch.
It was just after 12.40pm local time and passengers were preparing to settle in and cruise home to Perth.
Caroline remembers finishing her meal, noticing the fasten seatbelt sign was not on, and deciding to go to the bathroom.
“I’d gone to the toilet, so when I came out, I just remembered being hit on the back of the head with the overhead lockers and I was knocked out,” she said.
In two seconds, flight QF72 dived more than 45 metres and continued its descent.
Passengers and crew had been thrown around the cabin and the second officer activated the fasten seat belt sign.
The captain had wrestled back control but minutes later, the plane dived again.
“The plane hit me twice on the back of the head, and the third time I felt my feet go from under me,” Caroline said.
“My head definitely went through the locker. I think I was probably stuck on the ceiling for a while, I guess my head was in the locker.”
Caroline said she “woke up on the floor” of the plane.
“By that time I could feel my back was broken,” she said.
“And I couldn’t move my legs or anything at that stage and my ankle was broken and I had broken ribs and a cut face.”
More than 100 passengers and crew had been injured and the captain famously issued a mayday call and diverted to a remote air force base in Learmonth, Western Australia.
Caroline was fighting to stay alive and doing everything in her power to increase the chances of one day walking again.
“The problem is when you’re in an aircraft and you have a fracture, is that you get blood clots and blood clots had gone into my lungs, so it was it was quite harrowing,” she said.
“We were told to get back to our seats … and of course I couldn’t do that myself, so a passenger picked me up and put me in my seat, but that was really bad because I couldn’t sit … my spine was broken.”
Caroline said she gripped the armrest and used her arms to hold herself upright until the plane landed.
“I was concerned the bones would go through the [spinal] cord and it would have been way worse,” she said.
Just after 1.30pm local time, flight QF72 landed in Learmonth, but for Caroline and many others onboard, the impact of that incident lives on.
Aircraft bathrooms are ‘impact zones’
Bunk beds in economy, bars in business class and those dreamy one-bedroom suites in first class — these are all parts of an ever-evolving flying experience.
The thinking has always been that the height of luxury on a long haul flight is not being confined to an economy seat.
But there is one reality of flying that is hardly an extravagance — being able to get up and go to the toilet.
Even if you are vigilant about wearing your seatbelt low and tight for all the hours you are in your seat, what happens when you need to go? And how could that be made safer?
There are some measures within a passenger’s control, but it is also a question aviation regulators will have to answer.
Just days after a Singapore Airlines flight hit unexpected turbulence over Myanmar last month, a Qatar flight from Doha to Dublin was involved in another incident.
The turbulence that hit flight QR017 was not as severe, but still, eight passengers and crew were hospitalised.
In its last update, Singapore Airlines said 20 passengers and crew were still in hospital in Bangkok.
Some experts predict the Singapore Airlines incident will lead to design changes in future passenger jets, and potentially even rule changes around the fasten seatbelt sign.
Making flying safer involves the rules set by regulators, the policies of the airlines and the behaviour of passengers themselves.
Professor of human factors and aviation safety at the University of New South Wales Brett Molesworth said it was possible to “redesign impact zones”.
“So we know impact zones are the overhead lockers and then the ceiling in the bathrooms, so they can use material [that] reduces the severity of the impact in those circumstances,” he said.
“Because at the moment, little thought has gone into those areas.”
The risk of injury versus DVT
The dominant message to would-be flyers after the Singapore Airlines incident was that if you want to minimise your risk of injury due to the sudden movement of an aircraft, wear your seatbelt.
Typically at the start of a flight, passengers are told to keep their seatbelt fastened while seated.
But as the aircraft moves beyond the take-off phase of the flight, a familiar tone signals the fasten seat belt sign has been turned off and crew will no longer stop anyone from moving around.
That scenario means passengers have to weigh up the risks themselves, and of course, there are dangers that come from staying in your seat too long.
Dr Molesworth made the point that a turbulence event like on SQ321 is very rare and the risk of it happening is very hard for passengers to assess.
“Because it really depends on where the aircraft is flying and to a lesser extent, the altitude that the aircraft is flying at — it’s really difficult to make that risk assessment,” he said.
“To minimise the risk is to reduce the amount of time you’re out of your seat with the seatbelt off.”
Dr Molesworth said one way to do that was to minimise the amount of time spent waiting to use the bathroom, but said again, individuals had to make their own assessments.
“From a passenger’s perspective, they also need to be aware of their physical health, and if it is better for them to exercise in those circumstances and they can’t do that in the seat … they need to assess that risk.”
If the only danger was turbulence, then airlines might be more inclined to leave the fasten seatbelt sign on, but the norm is for passengers to be given a level of freedom.
“You have to balance the comfort of the passenger, especially on these ultra-long-haul flights — 17 hours sitting in a seat — there’s added risk of sitting for prolonged periods of time, [including] DVT, which is certainly well-known,” Dr Molesworth said.
He said dehydration was also a factor, so it was a “necessity” for passengers to know that they could go to the bathroom.
“If we look at the need to hydrate on aircraft, it’s greater than at surface level, so it just compounds the issue in those circumstances,” Dr Molesworth said.
The seatbelt sign
In the case of Singapore Airlines flight 321, several passengers have now hired legal representation and there is likely to be a focus on when the fasten seatbelt sign was turned on and if the turbulence could have been predicted.
In the initial report from the Singapore Transport Safety Bureau, investigators noted the aircraft was “likely flying over an area of developing convective activity” at 07:49:21 and would have likely started to experience “slight vibration”.
Then, according to the report, “at 07:49:32, it was heard that a pilot called out that the fasten seat belt sign had been switched on,” on the cockpit voice recording.
Just eight seconds later, “at 07:49:40, the aircraft experienced a rapid change in G” — within 0.6 seconds.
“This likely resulted in the occupants who were not belted up to become airborne,” the report reads.
Since the incident, Singapore Airlines has announced there will be changes to its seatbelt sign policy and says it has now adopted a “more cautious approach to managing turbulence in-flight”.
“In addition to the suspension of hot beverage service when the seat belt sign is on, the meal service will also be suspended,” the airline said in a statement to Singapore-based media.
“Crew members will also return to their seats and secure their seat belts when the seatbelt sign is on.”
The lasting impact of in-cabin injuries
Investigations into the Singapore Airlines incident, and the sudden drop experienced by a LATAM flight from Sydney to Auckland in March, are ongoing.
In the case of QF72, the final report by the Australian Transport Safety Bureau (ATSB) was published years ago.
The report noted at the time of the first nosedive, two people were in the toilets, at least 10 were standing near their seats and at least five were in the aisle.
The report noted: “Many of the non-seated passengers were reportedly on their way to or returning from a toilet.
“The remainder were attending to their children, requesting items from a flight attendant, or letting a passenger seated next to them out of their seat.”
The ATSB also published the results of a passenger survey conducted during its investigation.
The survey provided a snapshot of how a sudden movement could impact passengers at different locations on the plane while it was in a cruising phase of flight and the impact of seatbelt use.
Of the 98 passengers who completed the questionnaire, 29 reported that they were seated without their seat belt fastened. The questionnaire asked those passengers “why you were not wearing your seat belt?”
Ten of the passengers provided the following reasons:
- About to get up to go to the toilet or just returned from the toilet (seven responses)
- Been to the toilet and then forgot to refasten their seat belt (three responses).
All of these 10 passengers reported that they normally wore their seat belts during the cruise activities.
Caroline was 42 at the time of the QF72 incident and while she recovered from surgery, she used a wheelchair.
“It was very confronting,” she said.
“A lot of things went through my mind … I’m not going to be able to do anything that we could do before because we used to go boating and hiking.”
She was determined to walk again, and once her ankle healed, Caroline turned to that task.
“You have to retrain your brain to walk. I started off with six steps, then 10 steps, 20 steps and so on,” she said.
Caroline made a claim against Qantas, including for the disruption to her income-earning capacity.
The airline in turn claimed against the component manufacturers and the confidential settlement sums were paid by numerous UK and US underwriters.
The couple watched the events of SQ321 knowing those injured have a very long road ahead of them.
“I just feel so sorry for those people,” Caroline said.
She no longer likes to fly and has only managed two domestic flights since that life-changing event in 2008.
On both of those short flights, she has not taken her seatbelt off — Caroline has opted to not go to the bathroom.