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Many times 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 exercise keeps the 84-year-old camp elder healthy in mind and body, and allows him to monitor the welfare of other occupants.

His first stay in Mauritania occurred in 1991, when he escaped Mali as Tuareg rebels fought with the army in his home Timbuktu region.

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 mathematics and physics teacher says he feels especially sad for the younger people of Mbera, which is positioned 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 nation [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.”

Originally planned as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to UNHCR. In also, it is calculated that at least 154,000 refugees live 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 encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees pour in across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left large parts of the country uncontrollable. 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 ceased USAID – have severely slashed 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 discontinue vital 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 permanent settlement, including its own financial institution, eight schools, a market with more than 500 shops, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children registered in school. New entrants are processed by aid workers and state agents using digital identification.

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

Some residents have assumed new duties with enthusiasm: volunteers in the SOS Desert organisation grow crops for sale and manage an blaze control team putting out bushfires; members of a women’s resource network support those wounded by jihadist attacks and pregnant women while also promoting awareness about teaching girls.

But the camp’s needs are clear.

“We have the will, we have the women, but not enough funding or supplies,” 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 provided 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 largely basic, save for a few pulses.

“We’re still providing school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working continuously to secure new funding through the expansion of our funding sources.”

The meals are powered by recent gifts including several thousand tonnes of rice provided 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 farm and rear animals so they can make money and improve their livelihood.

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

“When you leave your country, you forfeit 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 endure hardship.

“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 pride.”