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A number of times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the enormous Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and permits him to check on the welfare of other occupants.

His first stay in Mauritania happened in 1991, when he escaped Mali as Tuareg separatists clashed with the army in his native Timbuktu area.

After four years as a refugee, he went back and worked for a year as a community worker before transitioning to a teacher. Then in 2012, the Tuareg unrest once again compelled him across the border.

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

“Some of the young ones who were born here in Mbera have never even seen Mali,” he says. “They do not know their homeland [and] that is painful because a refugee always has two hearts: 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 houses around 120,000 refugees, according to the UN refugee agency. In addition, it is approximated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government authorities say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees arrive across the border, running from a extremist rebellion that hijacked the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now defunct USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to halt essential nutrition programmes for hungry children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 shops, and volleyball and football initiatives. Members of a parent-teacher association use loudspeakers to get more children registered in school. New arrivals are processed by aid workers and state agents using biometric systems.

Nearby, security patrols protect the camp from the threat of militants just a few miles from the border.

Some residents have adopted new responsibilities with enthusiasm: volunteers in the SOS Desert organisation cultivate food for sale and operate an firefighting unit putting out bushfires; members of a women’s resource network support those wounded by jihadist attacks and expectant mothers while also promoting awareness about teaching girls.

But the camp’s demands are evident.

“We have the desire, we have the women, but not enough resources or supplies,” 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 offering school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working tirelessly to obtain new funding through the expansion of our funding sources.”

The meals are powered by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only products in a bulk of the warehouses. A few donors are also helping start entrepreneurship programmes to help refugees farm and raise animals so they can make money and improve their quality of life.

Though Malha supervises everything responsibly, helping the aid workers’ support the most disadvantaged households, his heart yearns to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is adequate, 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 dignity.”