For nearly a year now we've been using an 'outsourcing company' to handle most of our design needs. We work with the same guy on every project, so that he's familliar with our preferences. His English is better than that of most Americans, although surely not flawless when it comes to idioms and colloquial jargon.
For me, it's no different than placing a help wanted ad. The internet is global, and just because the applicant is in a 'third world' country does not make them any less competent. We enjoy the benefits of very different economies, and everyone is happy.
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