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Many mornings a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his dwelling since 2012. The exercise keeps the 84-year-old camp elder mentally and physically fit, and enables him to monitor the wellbeing of other residents.

His first stay in Mauritania occurred in 1991, when he left Mali as Tuareg separatists fought with the army in his native Timbuktu area.

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

The former mathematics and physics teacher says he feels particularly sorry for the young inhabitants of Mbera, which is situated 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 difficult 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 houses around 120,000 refugees, according to UNHCR. In furthermore, 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 officials say the area is the third largest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

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 lawless. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and neighbouring settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now discontinued USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to halt vital nutrition programmes for undernourished children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a permanent 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 amplifiers to get more children enrolled in school. New arrivals are registered by aid workers and state agents using digital identification.

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

Some residents have assumed new roles with gusto: volunteers in the SOS Desert organisation cultivate food for sale and run an anti-fire brigade putting out bushfires; members of a women’s resource network look after those maimed by jihadist attacks and expectant mothers while also spreading awareness about teaching girls.

But the camp’s demands are evident.

“We have the will, 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 demands 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 gather 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, basic food distributions, 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 obtain new funding through the expansion of our funding sources.”

The meals are supported by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping initiate entrepreneurship programmes to help refugees grow crops and raise animals so they can earn an income and enhance their livelihood.

Though Malha oversees everything dutifully, helping the aid workers’ support the most needy households, his heart longs 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 suffer.

“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.”