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Many days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp leader healthy in mind and body, and enables him to monitor the condition of other occupants.

His first stay in Mauritania happened in 1991, when he fled Mali as Tuareg insurgents battled with the army in his home Timbuktu area.

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 fighting once again compelled him across the border.

The former mathematics and physics teacher says he feels deeply sympathetic for the young inhabitants 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 country [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 longs to revisit 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 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 number three human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

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

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

The camp has many of the trappings of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children enrolled in school. New comers are documented by aid workers and state agents using biometric systems.

Nearby, police patrols secure the camp from the risk of fighters just a few miles from the border.

Some residents have assumed new duties with zeal: volunteers in the SOS Desert organisation cultivate food for sale and operate an anti-fire brigade putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and mothers-to-be while also promoting awareness about educating girls.

But the camp’s demands are evident.

“We have the determination, we have the women, but not enough financial support or materials,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the requirements 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 mostly unseasoned, save for a few legumes.

“We’re still supplying school meals, staple provisions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most at-risk while working continuously to secure new funding through the broadening of our funding sources.”

The meals are supported by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping start entrepreneurship programmes to help refugees cultivate and keep animals so they can make money and improve their standard of living.

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

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

“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 self-respect.”