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

His first stay in Mauritania came in 1991, when he left Mali as Tuareg rebels fought with the army in his native Timbuktu province.

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

The former mathematics and physics teacher says he feels particularly sorry for the younger residents of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have never even seen Mali,” he says. “They do not know their country [and] that is difficult because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

First established as a few thousand huts, Mbera now hosts around 120,000 refugees, according to UNHCR. In furthermore, it is calculated 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-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business capitals.

Each month, thousands more refugees come across the border, escaping a extremist rebellion that took over the Tuareg rebellion and has since left swathes of the country uncontrollable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby settlements – cannot stop being concerned. They have faced dwindling resources as foreign donors – most notably the now defunct USAID – have drastically cut funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both food or cash every month to about 53,000 … and had to discontinue essential nutrition programmes for malnourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a established settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children enrolled in school. New entrants are documented by aid workers and state agents using digital identification.

Nearby, gendarmerie patrols guard the camp from the threat of fighters just a few miles from the border.

Some residents have taken on new duties with enthusiasm: volunteers in the SOS Desert organisation grow crops for sale and operate an anti-fire brigade putting out bushfires; members of a women’s resource network look after those injured by jihadist attacks and mothers-to-be while also spreading awareness about educating girls.

But the camp’s needs are clear.

“We have the determination, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the needs of the camp.”

In the schools, the children are given 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 largely basic, save for a few pulses.

“We’re still offering school meals, staple provisions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to acquire new funding through the diversification of our donor base.”

The meals are supported by recent gifts including several thousand tonnes of rice donated by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping initiate self-sufficiency programmes to help refugees cultivate and keep animals so they can earn an income and enhance their standard of living.

Though Malha manages everything responsibly, helping the aid workers’ support the most needy 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 rely solely on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you endure hardship.

“We are grateful to 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.”