Disaster complexity and the Santiago de Compostela train derailment

Abstract

This disaster complexity case study examines Spain's deadliest train derailment that occurred on July 24, 2013 on the outskirts of Santiago de Compostela, Galicia, Spain. Train derailments are typically survivable. However, in this case, human error was a primary factor as the train driver powered the Alvia train into a left curve at more than twice the posted speed. All 13 cars came off the rails with many of the carriages careening into a concrete barrier lining the curve, leading to exceptional mortality and injury. Among the 224 train occupants, 80 (36%) were killed and all of the remaining 144 (4%) were injured. The official investigative report determined that this crash was completely preventable. KEYWORDSanthropogenic disaster; complex disaster; complexity science; disaster cascade; human-generated disaster; mass casualty incident; risk landscape; technological disaster; train derailment; transportation disasterThis case study was created by assembling a team of expert co-authors, including a mechanical engineer who is a renowned authority on transportation disasters, a trauma surgeon who directs a vehicle crash research center, and a team of disaster psychologists from Spain, rounded off by specialists in disaster health and complexity sciences. The complementary vantage points of these subject matter experts were blended together to reconstruct the cascading sequence of harmful events that took place. First, the engineer's perspective describes the mechanics of derailment and details the destructive demise of the train. Second, the surgeon tells how the passengers sustained deadly and injurious medical trauma as the carriages overturned, collided, and skidded along the retaining wall. Third, a team of Spanish disaster psychologists who respond to national emergencies explains the rippling psychosocial consequences that expand to affect the train crash survivors, the family members of the injured and deceased, the rescue personnel, the local population, and the citizens of Spain.This case study presents an interesting contrast to the official crash investigation. Employing simplicity thinking and linear logic, the official findings and the judicial rulings determined that the train driver was "exclusively" responsible for the crash. The analysis presented here applies complex systems thinking both upstream and downstream from the moment of the crash. The expert contributions tell the downstream sequence that began as the train entered the curve at excessive speed: derailment, train rollover and destruction, occupant death and injury, and psychological trauma and loss. Upstream, it was possible to identify a broader latticework of causal factors. This upstream component is particularly useful when searching for a more comprehensive set of preventive interventions CONTACT James M. Shultz

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