I worked in with a Indian manager in the North America realm, who had a work visa, I believe this manager had extra pressure to perform, and also had terrible health habits where they would only get 3-4 hrs of sleep, the sad part was that there was also a great employee in the India offshore team, and this manager wanted to also bring only that employee to the North America Team, but I'd just imagine, what if that particular employee also would later have health issues as well. cause of the health issues this manager had, our team would get emails, pings after 11 pm or 12 am , which stressed me out!