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A number of 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 dwelling since 2012. The activity keeps the 84-year-old camp elder healthy in mind and body, and allows him to check on the condition of other inhabitants.

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

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 unrest once again forced him across the border.

The former mathematics and physics teacher says he feels deeply sympathetic 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 not once visited Mali,” he says. “They do not know their country [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 dreams of returning to one day.”

First established as a few thousand dwellings, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In addition, it is approximated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government officials say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees arrive across the border, fleeing a militant uprising that hijacked the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop worrying. 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] support 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 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 arrivals are documented by aid workers and state agents using biometric systems.

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

Some residents have assumed new responsibilities with zeal: volunteers in the SOS Desert organisation farm produce for sale and manage an anti-fire brigade putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women while also spreading awareness about teaching girls.

But the camp’s demands are clear.

“We have the determination, we have the women, but not enough financial support or equipment,” a leading member of the network says. “Sometimes we repurpose what little we have, but it is not enough for the demands 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, essential food aid, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working tirelessly to acquire new funding through the expansion of our support network.”

The meals are funded by recent contributions including several thousand tonnes of rice supplied by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees grow crops and rear animals so they can earn an income and enhance their quality of life.

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

“When you leave your country, you lose 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 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.”