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Several mornings 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 residence since 2012. The activity keeps the 84-year-old camp leader vigorous, and enables him to check on the wellbeing of other occupants.

His initial 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 becoming a teacher. Then in 2012, the Tuareg fighting once again compelled him across the border.

The former mathematics and physics teacher says he feels especially sad 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 not laid eyes on 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 hopes to go back to one day.”

Initially conceived as a few thousand dwellings, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In also, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui province. 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, fleeing a extremist rebellion that took over the Tuareg rebellion and has since left extensive areas of the country uncontrollable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and neighbouring settlements – cannot stop being concerned. They have faced declining resources as foreign donors – most notably the now ceased USAID – have drastically cut funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both nutritional aid or money 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 features of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football initiatives. 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 digital identification.

Nearby, security patrols secure the camp from the threat of militants just a few miles from the border.

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

But the camp’s demands are clear.

“We have the determination, we have the women, but not enough financial support or materials,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the requirements of the camp.”

In the schools, the children are served one meal daily by WFP. At one school with 100 children per class, six or seven of them cluster by a big tray to eat the same meal every school day – rice that is almost plain, save for a few legumes.

“We’re still offering school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most vulnerable while working relentlessly to secure new funding through the broadening of our donor base.”

The meals are funded by recent gifts including several thousand tonnes of rice provided by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping launch self-sufficiency programmes to help refugees grow crops and keep animals so they can earn an income and enhance their livelihood.

Though Malha manages everything dutifully, helping the aid workers’ assist the most disadvantaged 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 depend only on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you endure hardship.

“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 self-respect.”