Syria's Kurds dreamt of an economic success story when they declared an autonomous region in the country's north, an area rich in oil resources and known as a breadbasket.
But instead their proto-state has become an island, squeezed economically on all sides and dependent on aid to make up for shortfalls in basic goods including food and medicine.
In his pharmacy in Qamishli, Mustafa Ebdi examined his dwindling stock.
"Most medication is missing," he told Agence France Presse, as a crowd of customers picked desperately through his sparse shelves.
"Our pharmacies are empty. We cannot find general anaesthetics or other medication used in surgery, as well as medication for diabetes," he added.
Location is largely to blame.