Cold Open

It’s just before 5 PM, on September 29th, 2006, 37,000 feet above the Brazilian rainforest.

On board an Embraer Legacy 600 business jet, First Officer Jan Paul Paladino tries to raise air traffic control on the radio—but just like the last few times he’s tried, he gets no answer.

He picks up a clipboard listing various air traffic control frequencies, then searches the cockpit for his glasses. It takes him a moment to find them. The cockpit’s layout is unfamiliar. Paladino has never flown a Legacy 600 before. And no one has ever flown this specific plane.

Three hours ago, the business jet took off from a small airport near Sao Paulo on its maiden flight, bound for New York with five passengers. Things aren’t off to a good start. As Paladino flips through the clipboard’s pages… the cockpit door opens, and Paladino’s co-pilot, Captain Joseph Lepore, takes his place on the flight deck.

Captain Lepore apologizes for being away so long, saying he had repaired a blocked toilet, and asks if there’s anything he missed. Paladino glances up and answers that he can’t contact Brazilian air traffic control. He thinks the Legacy 600 might be on the wrong frequency.

While Paladino fiddles with the radio, the aircraft suddenly begins to shake violently. As it veers to the left, Paladino pulls on the control column and corrects the aircraft, but the plane still feels unstable. After a moment’s hesitation, Captain Lepore declares they should begin an emergency descent.

He shouts back to the cabin, telling the passengers to sit down and buckle up. A panicked voice answers back that the tip is missing from one of the wings. Paladino leans forward, peers out of the cockpit side window, and sees that the passenger is right. Part of the wing has somehow completely sheared off. Paladino has no idea how this could have happened at 37,000 feet. One thing is clear: they need to get on the ground as quickly as possible.

Within a few minutes, the jet lands at a nearby Brazilian Air Force base. Paladino examines the plane’s damaged wing and concludes they had a lucky escape. Unfortunately, not everyone else did.

Soon, news will filter through that Gol Flight 1907— a Boeing 737 carrying 154 people, has disappeared from radar. With a lurch in his stomach, Paladino will realize that the two planes must have collided in midair.

The disaster will plunge the Brazilian aviation industry into crisis, one which will be prolonged by a second, even more deadly accident, just months after the tragic crash of Gol Flight 1907 on September 29th, 2006.

Introduction

From Noiser and Airship, I’m Lindsay Graham and this is History Daily.

History is made every day. On this podcast—every day—we tell the true stories of the people and events that shaped our world.

Today is September 29th, 2006: Crisis in Brazil’s Skies.

Act One

It’s early October 2006, at Cachimbo airbase in central Brazil, a few days after the midair collision between a business jet and Gol Flight 1907.

First Officer Jan Paul Paladino squirms uncomfortably in his seat in a hot, stuffy interview room. Paladino is being questioned by a Brazilian air accident investigator—and it’s becoming clear that the investigator thinks the crash was the fault of First Officer Paladino and his fellow pilot, Captain Joseph Lepore.

Soon after Paladino’s damaged business jet made an emergency landing, a search-and-rescue operation began to scour the dense rainforest for the missing Gol Flight 1907. The Boeing 737 wasn’t spotted until the following day. Debris from the crash site was scattered across a wide area, suggesting a high-speed impact. Brazilian soldiers rappelled to the wreckage from helicopters and reported no survivors from the 154 passengers and crew.

With no one to rescue, the investigation shifts focus. Now, officials are determined to uncover how the two planes ended up on a collision course.

The investigator asks Paladino about the flight plan Captain Lepore submitted before they took off. Paladino replies that they were en route to a refueling stop and were cleared to fly at 37,000 feet. The investigator interrupts though, stating that the listed flight plan has the business jet flying at 36,000 feet. But Paladino insists that air traffic control overrode that plan and told them to remain at 37,000 feet.

Next, the investigator asks why the transponder in Paladino’s plane was turned off. If it was on, collision alarms would have sounded in both planes, likely preventing the whole tragedy.

But of course, Paladino already knows that. For the past few days, he’s thought about little else. But he doesn’t have a good answer. He doesn’t know why the transponder was turned off. Perhaps it malfunctioned. Or perhaps Captain Lepore turned it off by accident. The cockpit layout was unfamiliar to them, and it’s possible that they may have bumped it at some point without realizing.

The investigator gives a curt nod and closes his notepad. As he rises from his chair, he tells Paladino that the interview is over.

Paladino then asks when he’ll be able to return home to the United States. But the investigator says that's not going to be possible. A judge has authorized the seizure of First Officer Paladino and Captain Lepore’s passports. The two pilots will be required to stay in Brazil until the investigation is complete.

For the next six weeks, the search for answers continues. Air crash investigators scour the debris field left by Gol Flight 1907 and recover the flight data and cockpit voice recorders from the doomed plane. By analyzing the audio recordings and the wreckage, investigators conclude that the two planes touched wings as they flew past each other in opposite directions. Although the Boeing 737 was the larger aircraft, the way in which the wings touched meant that it suffered far greater damage. While the business jet only lost the tip of a wing, the 737’s wing snapped in half. The airliner instantly dropped into an uncontrollable spin, reaching such high speeds that it broke up before it even hit the ground.

On November 16th, 2006, the lead investigator, Colonel Rufino Antonio da Silva Ferreira, stands before an audience of journalists in a packed conference hall and tries to explain this series of events. Colonel Ferreira points to a diagram projected on a wall showing outlines of a Legacy 600 and a Boeing 737, and where the damage to each plane occurred.

But the journalists interrupt the Colonel with questions. They don’t just want to know what happened. They want to know why.

Colonel Ferreira announces that the investigation blames two different parties for the disaster. The American pilots in the business jet will be charged with endangering an aircraft because they turned off the transponder. But several Brazilian air traffic controllers also failed to properly track the course of the jet and missed opportunities to intervene. Colonel Ferreira reveals that they too will be prosecuted.

This news will not be well received by Brazil’s air traffic controllers, who fear that individual controllers are being made scapegoats to cover up a failing system, one that’s left aviation workers underpaid and overworked. But their concerns will go unaddressed until another shocking tragedy will force radical reform.

Act Two

It’s the evening of March 30th, 2007, at an air traffic control center in Brasilia, the capital of Brazil, six months after the crash of Gol Flight 1907.

An air traffic controller sits at his desk, staring at a screen. It’s filled with symbols that represent the planes under his zone of control – though there are fewer than he’s used to. The controller has spent his shift ensuring his screen is quieter than normal because he’s about to go on strike.

After investigators partly blamed failures in air traffic control for the crash of Gol Flight 1907, several controllers were arrested. The colleagues of those detained complained that it wasn’t the controllers at fault—it was the system in which they worked.

Over the past three years, demand for air travel has grown fifteen percent annually in Brazil, but requests for additional funding to employ more controllers and upgrade air traffic computer systems have been rejected by the Brazilian government. Even after the crash of Gol Flight 1907, these issues have not been dealt with. So, in an effort to draw attention to chronic understaffing and underinvestment, air traffic controllers have begun doing only the minimum required of them – refusing overtime and clocking off as soon as their shift ends.

Now, the controllers have decided to escalate their action.

The air traffic controller checks his watch, nods at a colleague at a neighboring desk, and then takes off his headset. Several other controllers do the same. Together, they walk from the room, watched by the handful of colleagues who’ve opted to stay behind to ensure the skies are kept safe. The controllers who walk out risk arrest. Brazilian law forbids them from striking—but they feel they have little option; they must take a stand to prevent more lives being lost in the air.

Within minutes of the controllers’ walkout, the manager of the control room declares an emergency. Flights are delayed. Planes in the air are directed away from Brazilian airspace. Fights break out in airports as frustrated passengers take out their anger on airline staff and each other. And after hours of chaos, government officials offer a deal that gets the air traffic controllers back to work. But it’s little more than a temporary solution, one that does little to solve the systemic problems they face. Air traffic controllers continue to complain that another accident will happen unless more is done to upgrade Brazil’s aviation network. But their pleas fall on deaf ears.

Three months later, on July 17th, 2007, Captain Henrique Stefanini Di Sacco stands in the galley of his Airbus A320 at Porto Alegre Airport in southern Brazil. He greets the passengers as they board his aircraft for their flight to Sao Paulo.

Captain Di Sacco would normally spend his time conducting pre-flight checks. But most Brazilians are increasingly disillusioned with air travel, thanks to the delays and cancellations that have resulted from air traffic control strikes and slowdowns. So, in a bid to boost public relations, management at Brazil’s TAM Airlines have insisted that pilots leave the cockpit, and welcome the passengers as they come aboard.

Personally, Captain Di Sacco thinks the time spent shaking hands has little effect on the frustrated passengers. If anything, it only increases the pressure to keep his plane on schedule. But Captain Di Sacco has no say in the matter. He simply does what he’s told.

TAM Flight 3054 eventually leaves Port Alegre at 5:18 PM. Ninety minutes later, after an incident-free flight, Captain Di Sacco makes his final approach to the notoriously difficult runway at Sao Paulo’s Congonhas Airport. As the plane lands, he engages the thrust reverser to slow down the aircraft. The left engine responds to his commands, but the right engine thrust reverser does not deploy. Instead of slowing the plane, the right engine accelerates. And with one side of the plane braking and the other side at full thrust, Captain Di Sacco loses control and the Airbus A320 veers off the runway. It hurtles into a warehouse and explodes.

Emergency services can do little to stop the conflagration. By the time the flames are extinguished, it’s clear that all 187 passengers and crew aboard the plane have died. In addition, twelve people on the ground are killed. Just nine months after the crash of Gol Flight 1907, a new accident has surpassed it as Brazil’s deadliest air disaster.

An investigation will be unable to definitively conclude whether TAM Flight 3054 crashed as a result of mechanical failure or pilot error. But regardless of the cause, the accident will be another blow to Brazil’s airlines, which are already struggling to attract passengers after months of disruption. It will take years to recover from these crises and give Brazilians an aviation industry that they can have confidence in.

Act Three

It’s November 2010 at Cachimbo airbase, four years after the midair collision which started the Brazilian aviation crisis.

A pilot opens the throttle and holds the control column as his airplane accelerates down the runway. When it reaches takeoff speed, he pulls back on the controls and the plane lifts into the air. For the first time since it was involved in an accident that killed 154 people, the Embraer Legacy 600 business jet is airborne.

Following the crash of Gol Flight 1907, this Legacy 600 was impounded at Cachimbo airbase. After four years, it was sold to a new owner who had the plane repaired and reregistered. Now, the Legacy 600 is finally on its way to the United States, where it will carry executives to meetings across the country—most of whom have no idea of the tragedy that occurred on the plane’s maiden flight.

After changing hands once more in 2013, this business jet is still in service today. Meanwhile, much of the wreckage of the Boeing 737 with which it collided remains at the crash site, where it’s being slowly consumed by thick rainforest.

But the legacy of Gol Flight 1907 endures. After the crash sparked an aviation crisis that crippled Brazilian air travel, the media, both in Brazil and internationally, have scrutinized the accident, its causes, and the subsequent investigations, leading to more public awareness about aviation safety issues. The institutional failings that many employees complained of have started to be addressed, and the Brazilian government has implemented a number of safety reforms and air traffic systems in Brazil have been gradually upgraded to prevent a similar tragedy occurring today— but some experts still suggest that more could be done to prevent a disaster like the midair collision that caused one of Brazil’s deadliest aviation accidents on September 29th, 2006.

Outro

Next on History Daily. October 2nd, 1944. After two months of fighting, Polish rebels fail to liberate Warsaw from Nazi occupation.

From Noiser and Airship, this is History Daily, hosted, edited, and executive produced by me, Lindsay Graham.

Audio editing by Muhammad Shahzaib.

Sound design by Katrina Zemrak.

Music by Lindsay Graham.

This episode is written and researched by Scott Reeves.

Executive Producers are Alexandra Currie-Buckner for Airship, and Pascal Hughes for Noiser.