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Many days 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 home since 2012. The activity keeps the 84-year-old camp elder mentally and physically fit, and permits him to check on the welfare of other inhabitants.

His first stay in Mauritania came in 1991, when he left Mali as Tuareg rebels battled with the army in his home Timbuktu area.

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

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

“Some of the kids 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.”

First established as a few thousand huts, Mbera now hosts around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In furthermore, it is estimated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government representatives say the area is the third-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, escaping a extremist rebellion that hijacked the Tuareg rebellion and has since left large parts of the country lawless. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and adjacent settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now discontinued USAID – have severely slashed 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 vital nutrition programmes for hungry children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a permanent 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 processed by aid workers and state agents using fingerprint technology.

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

Some residents have taken on new roles with zeal: volunteers in the SOS Desert organisation farm produce for sale and run an firefighting unit putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and mothers-to-be while also promoting awareness about schooling girls.

But the camp’s demands are obvious.

“We have the desire, we have the women, but not enough funding or supplies,” a leading member of the network says. “Sometimes we repurpose 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 almost plain, 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 prioritizing the most at-risk while working tirelessly to secure new funding through the diversification of our support network.”

The meals are powered by recent contributions 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 launch business programmes to help refugees grow crops and keep animals so they can make money and enhance their livelihood.

Though Malha oversees everything dutifully, helping the aid workers’ cater to the most vulnerable households, his heart aches to return to Mali.

“When you leave your country, you lose everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you suffer.

“We appreciate 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.”