US Management seem to be focusing on global growth rather than ensuring their staff are supported and their current overseas offices are operating as well as they could be
Exploitative business model - especially for local staff (who were all amazing) they are paid badly and work in high stress environments with little support and training as everything is done on a shoe-string budget. They wouldn't expect US staff to do such traumatic work on equivalent salaries with little support but is deemed acceptable in their country offices.
Loss of institutional knowledge - crazy high staff turnover so continuity of work isn't great, cases are lost, clients have to deal with constantly changing advocates
Combination of these factors means there isn't as much downward accountability to the populations they are serving as there should be.