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A number of times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp elder mentally and physically fit, and enables him to check on the wellbeing of other residents.

His initial stay in Mauritania came in 1991, when he fled Mali as Tuareg rebels battled with the army in his home Timbuktu region.

After four years as a refugee, he returned home and worked for a year as a community worker before transitioning to a teacher. Then in 2012, the Tuareg conflict once again pushed him across the border.

The former math and science teacher says he feels deeply sympathetic for the young people of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their nation [and] that is heartbreaking because a refugee always has dual loyalties: one here, where he lives, and another over there, in his homeland, which he hopes to go back to one day.”

Initially conceived as a few thousand shelters, Mbera now hosts around 120,000 refugees, according to UNHCR. In furthermore, it is calculated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government authorities say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, running from a militant uprising that took over the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now defunct USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt vital nutrition programmes for malnourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a permanent settlement, including its own bank, eight schools, a market with more than 500 stores, and volleyball and football initiatives. Members of a parent-teacher association use loudspeakers to get more children registered in school. New comers are documented by aid workers and state agents using digital identification.

Nearby, security patrols secure the camp from the threat of armed groups just a few miles from the border.

Some residents have adopted new duties with zeal: volunteers in the SOS Desert organisation grow crops for sale and operate an blaze control team putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and pregnant women while also promoting awareness about schooling girls.

But the camp’s needs are obvious.

“We have the desire, we have the women, but not enough financial support or materials,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the requirements of the camp.”

In the schools, the children are served one meal daily by WFP. At one school with 100 children per class, six or seven of them gather by a big tray to eat the same meal every school day – rice that is mostly unseasoned, save for a few pulses.

“We’re still supplying school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working relentlessly to acquire new funding through the broadening of our funding sources.”

The meals are funded by recent donations including several thousand tonnes of rice donated by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping initiate business programmes to help refugees grow crops and rear animals so they can earn an income and boost their livelihood.

Though Malha supervises everything dutifully, helping the aid workers’ assist the most needy households, his heart yearns to return to Mali.

“When you leave your country, you lose everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is enough, sometimes it is not. And when it is not, you struggle.

“We thank the Mauritanian authorities and the humanitarian organisations for what they have done for us but it is not the same as being in your own country, working with your own hands and living with pride.”