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Several days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp leader mentally and physically fit, and permits him to assess the condition of other occupants.

His first stay in Mauritania came in 1991, when he left Mali as Tuareg insurgents battled 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 unrest once again pushed him across the border.

The former math and science teacher says he feels particularly sorry for the young inhabitants of Mbera, which is positioned 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 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.”

Initially conceived as a few thousand shelters, Mbera now hosts around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In also, it is calculated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government representatives say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees arrive across the border, escaping a extremist rebellion that took over the Tuareg rebellion and has since left large parts of the country lawless. 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 worrying. They have faced shrinking resources as foreign donors – most notably the now ceased USAID – have drastically cut 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 crucial nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a established settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football programmes. Members of a parent-teacher association use loudspeakers to get more children signed up in school. New entrants are registered by aid workers and state agents using fingerprint technology.

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

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

But the camp’s needs are evident.

“We have the determination, we have the women, but not enough funding or materials,” 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 sit 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 supplying school meals, basic food distributions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to secure new funding through the broadening of our support network.”

The meals are supported by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only goods 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 make money and enhance their quality of life.

Though Malha manages everything dutifully, helping the aid workers’ assist the most vulnerable 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 depend only 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 pride.”