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The main issue facing non US/CAN residents is geographic restriction. This is where the publisher prevents some titles from being sold outside a certain region. In most cases that would be US/CAN.
The ebook store (including Amazon) will often check your IP or your credit card/Paypal billing address, thus preventing purchase of the geographically restricted ebook.
There are many ways around the system and one method that works with one website may not work with another website.
With Amazon, a VPN or IP hiding proxy usually suffices quite well, allowing you to purchase the title you want to purchase.
Geographic restrictions are the single most frustrating issue I find currently, even more so than DRM of which removal is relatively easy.
I hope that answers your question.
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