An actual Kindle, in most cases, has to be registered to a particular market-place and only ebooks there can be bought. Obviously this doesn't apply to an app.
You can be based in most countries and buy a Gift voucher in the market place where it will be used. A gift voucher can't be used in a different market place. It can be bought for someone giving the email address that Amazon has for the recipient. Once applied to an account it can only be used on Amazon, excluding Card payments or Gift vouchers, not transferable.
Amazon certainly last year or before started detecting non-domestic USA addresses and would not allow even digital sales to them.
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