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A number of times a week, Mohamed ‘Momo’ Ag Malha treks 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 elder mentally and physically fit, and allows him to assess the welfare of other inhabitants.

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

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

The former math and science teacher says he feels especially sad for the younger inhabitants of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have not once visited Mali,” he says. “They do not know their country [and] that is difficult 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 shelters, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In furthermore, it is approximated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government representatives say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, running from a extremist rebellion that took over the Tuareg rebellion and has since left extensive areas of the country ungovernable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now defunct USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to stop vital nutrition programmes for malnourished children and mothers due to funding cuts,” 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 outlets, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children signed up in school. New arrivals are processed by aid workers and state agents using biometric systems.

Nearby, police patrols secure the camp from the threat of armed groups just a few miles from the border.

Some residents have taken on new roles with zeal: volunteers in the SOS Desert organisation grow crops for sale and run an firefighting unit putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and pregnant women while also raising awareness about schooling girls.

But the camp’s demands are obvious.

“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 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 offering school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working continuously to obtain new funding through the expansion of our donor base.”

The meals are supported by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only items in a majority of the warehouses. A few donors are also helping initiate self-sufficiency programmes to help refugees grow crops and raise animals so they can generate funds and improve their livelihood.

Though Malha manages everything responsibly, helping the aid workers’ support the most disadvantaged households, his heart longs to return to Mali.

“When you leave your country, you forfeit 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 struggle.

“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.”