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Many days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and allows him to assess the welfare of other occupants.

His first stay in Mauritania occurred in 1991, when he fled Mali as Tuareg rebels clashed with the army in his native Timbuktu region.

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 particularly sorry for the younger 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 never even seen Mali,” he says. “They do not know their homeland [and] that is heartbreaking because a refugee always has split affections: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

Initially conceived as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to UNHCR. In addition, it is calculated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government representatives say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

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 uncontrollable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby settlements – cannot stop feeling anxious. 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] help almost 90,000 people with both food or cash every month to about 53,000 … and had to halt vital nutrition programmes for hungry children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a established settlement, including its own bank, 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 signed up in school. New entrants are registered by aid workers and state agents using digital identification.

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

Some residents have adopted new duties with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and run an firefighting unit putting out bushfires; members of a women’s resource network support those wounded by jihadist attacks and expectant mothers while also promoting awareness about schooling girls.

But the camp’s needs are clear.

“We have the determination, we have the women, but not enough resources or supplies,” 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 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 almost plain, save for a few legumes.

“We’re still supplying school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most vulnerable while working continuously to obtain new funding through the broadening of our support network.”

The meals are funded by recent donations including several thousand tonnes of rice donated by the South Korean government – the only items in a majority of the warehouses. A few donors are also helping start business programmes to help refugees cultivate and raise animals so they can make money and enhance their livelihood.

Though Malha manages everything dutifully, helping the aid workers’ support the most needy households, his heart aches to return to Mali.

“When you leave your country, you sacrifice everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is enough, sometimes it is not. And when it is not, you struggle.

“We thank 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.”