The Mount Bromo tourist area was closed completely from 6 to 18 September 2023 after a savanna fire started by a flare during a pre-wedding photo shoot. The fire was declared out only on 15 September 2023, and visits resumed on 19 September 2023 at 00.01 WIB, with a ban on bringing fireworks, firecrackers and flares and on lighting campfires (Puspa, 2023). The Bromo Tengger Semeru National Park authority (BB TNBTS) recorded about 504 hectares affected, the total of several fires in the area during August and September 2023 (ANTARA, 2023a).
This case study summarises the event as described in official statements quoted by the media, then reads it through a layered defence model. At the time of writing no official technical investigation report has been published. Police have named one suspect (Rofiq, 2023) and losses are still being calculated (Aminudin, 2023), so the account below assigns no cause beyond what the authorities have stated.
The Event in Brief
According to the Probolinggo police chief, six people set out to shoot pre-wedding photos on the Bukit Teletubbies savanna on Wednesday, 6 September 2023. One session used five smoke flares, lit to match the concept of the wedding organiser hired for the shoot. One flare failed to light and then burst, and its sparks set the savanna alight, so the fire spread quickly. The fire was reported to the park management at about 11.30 WIB, and the next day its extent was put at about 50 hectares. Park staff, Tengger residents and volunteers fought the fire in strong wind and steep terrain. One person was named a suspect, while the other five were treated as witnesses (Rofiq, 2023).
It was not the first fire of the season. The first fire in the Mount Bromo area broke out on 29 August 2023 at 23.30 WIB in the Bantengan area, followed by a fire in a Perhutani forestry area that affected the Penanjakan viewpoint, each followed by partial closure of tourist access (ANTARA, 2023a). The park authority stressed that the area is a conservation area under Law Number 5 of 1990, with prohibitions and sanctions set out in Government Regulation Number 28 of 2011 (Aminudin, 2023).
Identified Factors
From the official statements, four factors can be noted without speculation. First, the ignition source: a flare that failed to light and then burst (Rofiq, 2023). Second, the fuel: dry savanna grass. Third, the weather: since July 2023 BMKG had warned that El Niño and a positive Indian Ocean Dipole were reinforcing each other to make this year's dry season drier, with a threat of forest and land fires (ANTARA, 2023b). Fourth, strong wind and steep terrain that hampered firefighting (Rofiq, 2023).
Layered Defence Analysis
We use Reason's (2000) Swiss cheese model, which sees an accident as the result of holes in several layers of defence that happen to line up. The holes consist of active failures at the front line and latent conditions created by decisions higher in the organisation. Reason also warns that an approach that only blames individuals tends to repeat the same errors.
Within that frame, lighting the flare is the visible active failure. The earlier layers that we think investigators should examine are the planning of commercial activities in a fire-prone area, the control of fire-starting items at entry points, and the information on fire danger given to visitors and service providers. The fact that the ban on flares and fireworks was spelled out when the area reopened (Puspa, 2023) shows that this layer was strengthened afterwards. As an unverified hypothesis, the quality of the flares and the handling of a flare that fails to light also deserve examination as a technical layer. The limits of this analysis are clear: the only data available are official statements in the media, not an investigation report.
Lessons for Workplaces
The same pattern can arise at factories, warehouses, plantations or construction sites in the dry season, especially in hot work and non-routine activities. The lessons we draw are:
- Treat every open flame source, including pyrotechnics for events, as hot work that needs a permit to work and a hazard analysis beforehand.
- Raise the level of control when official agencies declare a drier dry season, for example by postponing hot work near dry grass or combustible material (ANTARA, 2023b).
- Control fire-starting items at the entry points of fire-prone areas, not only through appeals (Puspa, 2023).
- Prepare an emergency response plan that accounts for wind and terrain access, not just the number of extinguishers (Rofiq, 2023).
- Investigate incidents by tracing every layer of defence rather than stopping at the last person who acted (Reason, 2000).
How Nusa Safety Helps
Nusa Safety helps companies put controls in place before risky work begins. Through the risk assessment and JSA workshop, the Nusa Safety team trains field teams to recognise ignition sources, fuel and weather conditions in every work plan. Fire readiness can be tested through emergency preparedness drills, and learning from incidents can be deepened through incident investigation and RCA training. To discuss the needs of a specific workplace, please contact the Nusa Safety team.
This article is general information and not legal or professional advice for any specific case.
References
- Aminudin, M. (2023, September 16). Luas kebakaran Bromo capai 504 hektare, TNBTS masih hitung total kerugian. detikJatim. https://www.detik.com/jatim/berita/d-6934461/luas-kebakaran-bromo-capai-504-hektare-tnbts-masih-hitung-total-kerugian
- ANTARA. (2023a, September 15). BB TNBTS: Kerusakan akibat karhutla di kawasan Bromo capai 504 hektare. ANTARA News Yogyakarta. https://jogja.antaranews.com/berita/635262/504-hektare-kawasan-gunung-bromo-rusak-akibat-terbakar
- ANTARA. (2023b, July 22). BMKG ingatkan ancaman gagal panen dan karhutla imbas El Nino. ANTARA News Sumatera Utara. https://sumut.antaranews.com/berita/539232/bmkg-ingatkan-ancaman-gagal-panen-dan-karhutla-imbas-el-nino
- Puspa, U. (2023, September 18). Wisata Gunung Bromo dibuka lagi, pengunjung dilarang bawa alat pemicu kebakaran. Lingkar.news. https://lingkar.news/jatim/wisata-gunung-bromo-dibuka-lagi-pengunjung-dilarang-bawa-alat-pemicu-kebakaran
- Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768-770. https://doi.org/10.1136/bmj.320.7237.768
- Rofiq, M. (2023, September 7). Kronologi lengkap flare prewedding picu terbakarnya Bukit Teletubbies Bromo. detikJatim. https://www.detik.com/jatim/hukum-dan-kriminal/d-6919347/kronologi-lengkap-flare-prewedding-picu-terbakarnya-bukit-teletubbies-bromo
