Our company is pushing hard to expand the amount of our work done offshore - namely in India. Comments from those who have experience in working with the sub-continent have mentioned issues with coordination across global distances and timezones but invariably the issue of communication comes up. There have been complaints about understanding the accent of those not raised speaking American English. I have experienced this and found that the situation improves with time, no doubt due to my own ears acclimating themselves.
Another observation made was that the team members on the other side of the phone line seem to struggle to understand American speaker's comments and questions. One sign of this is when the same questions are asked over and over again. Somehow the answers are just not getting through.
I must admit my first thought is, "Gee, their English must not be very good." But now it occurs to me that the trouble may well be my accent! An accent is all in the ear of the hearer. If someone in India has limited exposure to a southern-tinged way of speaking, especially one not trained in elocution to the degree common in actors and TV journalists, we should not be surprised if they have a little trouble cutting through our southern drawl or even a northern twang.
Once again, Humility proves the greatest virtue.