HRO3 A Fire Aboard Ship Can Ruin Your Day ...
Readers have likely heard about the multi-day fire aboard the USS BONHOMME RICHARD (LHD 6). As I write this, the fire is out and the Naval Sea Systems Command (NAVSEA) damage assessment is in progress. There is also a safety investigation to assess causes and the response to the fire. I have read creative as well as unimaginative news articles related to the fire. Their common feature is lack of facts. Here is a sample of what you can find online:
The Navy’s Cultural Ship is Listing-the service is trying to do too much with too little public support as the chain of command frays. -> How you connect a fire on one ship to public support, chain of command, and culture across the entire Navy is a mystery to me.
Navy officials fear [this] and said [that] -> I think it is unwise to have ANY confidence in a story whose author does not name his or her sources (“according to experts” ranks right up there with “we’re here to help” as a statement of dubious validity). Who cares who fears what until the damage assessment is complete?
The fire shouldn’t have happened (“should have been completely preventable,” “the Navy is supposed to have good practices”) and the fire should have been extinguished faster (“the Navy should be able to fight [fires] immediately”) -> Neither observation is particularly illuminating since the Navy is composed of people that don’t always do what people expect. This is very inconvenient, but not surprising from an HRO perspective.
“Burning USS Bonhomme Richard Signals More Trouble for Navy” (“The latest incident in a long line of recent trouble suggests continued internal weakness”) -> Perhaps it depends on how far back you want to draw the “long” line and what the “line” connects. More trouble? No doubt about that. This is what my brother calls a “Captain Obvious” statement.
Clearly, there are lots of opinions about the fire, its causes, Navy culture, and connecting lines written by people who lack reticence to project trends without reliable data. For just a little grounding in reality instead of speculation, here are some basic facts of Navy ship fire safety:
Every crew member of a Navy ship is trained in basic fire fighting and there are periodic refreshers. Aviation capable ships like the USS BONHOMME RICHARD do even more training because senior leaders recognize they are floating fuel storage facilities beneath airports staffed by people with an average age of 19.
Ship crews (not “ships”) have to periodically demonstrate their ability to combat fires big and small (but it’s against simulated fires so there can be a gap between subjective evaluations and actual performance).
Every ship is equipped with extensive quantities of high tech fire fighting equipment, but it takes a lot of organization and effort to keep it functional.
To reduce the risk of fire, there are regulations that limit the volume of flammable liquids, how they should be stored, and specify the conditions of the storage spaces.
There are extensive Navy requirements to do regular inspections of every ship compartment to identify fire hazards and the functionality of fixtures designed to limit damage from fires and flooding. The quality and frequency of external assessments of these inspections vary. Each compartment is supposed to be inspected at least annually.
Anytime hot work (burning with blowtorches or welding) is done, there are Navy requirements for detailed safety checks to remove fuel for fires, provide ventilation, and ensure the air isn’t subject to explosion.
Fighting fires aboard ship is crazy difficult even when there isn’t a lot of flammable material at risk of exploding and all the gear works. If you want to get an idea of how hard it is, put on long underwear, then a snowsuit, ski helmet, and boots, shoulder a pack that weighs forty pounds, turn your heating system all the way up, blindfold yourself, wear earplugs, put a snorkel in your mouth, then try to explain the theory of relativity to ten people operating shop vacuum cleaners in your living room while ten other people are spraying all of you with water and still ten more keep running in and out of the room interrupting you with updates on the state of your plumbing and household appliances. Make sure you provide status reports every five minutes on how things are going. This is a good simulation of shipboard fire fighting minus the toxic smoke and should provide perspective lacking from anyone that claims sailors should be able to put out fires aboard ship immediately.
With those facts in hand, here are some things to consider:
Whenever you have a fire that lasts for days, reaches 1200F, and results in explosions, it suggests that flammable material in excess of authorized limits was stored somewhere where it wasn’t supposed to be. The official investigation will identify the causal linkage for the fire, but I think it won’t be very complicated.
There have been some reports that the source was not hot work. The reports don’t matter because the cause will be a focus of the investigation and then we will KNOW. Hot work is the typical source of ignition in ships undergoing extensive maintenance , but fires can result from other sources like arson (USS MIAMI), electrical equipment (ARA SAN JUAN), and smoking outside approved areas, very close to unauthorized flammable material storage (hat tip to Kevin Erskine) for USS GEORGE WASHINGTON).
Any opinion about what the fire fighting crews should have been able to do how quickly prior to publishing the official investigation is uninformed.
Prior to NAVSEA’s technical assessment of the damage, it is foolish to “fear” the ship will need to be decommissioned or need “hundreds of millions of dollars to repair.” The damage could be comparable to USS MIAMI (2012 fire with $500M repair estimate) or USS GEORGE WASHINGTON (fire in 2008 that cost less than $100M to repair). The decision not to repair the MIAMI was far more complicated than “gee, that costs a lot.” So it will be for the BONHOMME RICHARD.
My final observation that connects this post to High Reliability Organizing (HRO) is that the efficacy of all the important actions related to fire safety, fire fighting training, inspections, equipment, and storage of flammable material is dependent on the humans responsible for doing the work, supervising it, and checking that it got done. HRO requires a rigorous process of ensuring the people responsible for the work are qualified to do it, regularly train to do it, and are checked by knowledgeable leaders that are involved the details.
An HRO approach to fire safety would be that every important part of a ship’s fire safety system (including the ability to fight fires) gets rigorously audited. To paraphrase a former director of Navy Nuclear Propulsion, it is far better to know the condition of your fire safety system before a mass conflagration than investigate it afterward.
