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A number of days 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 dwelling since 2012. The exercise keeps the 84-year-old camp leader mentally and physically fit, and permits him to assess the condition of other inhabitants.

His first stay in Mauritania happened in 1991, when he escaped Mali as Tuareg rebels clashed with the army in his native Timbuktu area.

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 forced him across the border.

The former mathematics and physics teacher says he feels deeply sympathetic for the young residents 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 heartbreaking because a refugee always has dual loyalties: 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 huts, Mbera now hosts 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 area. More than half are under 18.

Government authorities say the area is the number three human community in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees arrive across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left swathes of the country uncontrollable. 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 worrying. They have faced declining resources as foreign donors – most notably the now defunct USAID – have severely slashed 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 essential nutrition programmes for hungry 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 activities. Members of a parent-teacher association use amplifiers to get more children enrolled 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 taken on new duties with gusto: volunteers in the SOS Desert organisation grow crops for sale and run an blaze control team putting out bushfires; members of a women’s resource network support those maimed by jihadist attacks and mothers-to-be while also raising awareness about educating girls.

But the camp’s needs are obvious.

“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 needs 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 sit by a big tray to eat the same meal every school day – rice that is almost plain, save for a few beans.

“We’re still supplying school meals, staple provisions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working tirelessly to secure new funding through the expansion of our funding sources.”

The meals are powered by recent donations including several thousand tonnes of rice supplied by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping start business programmes to help refugees grow crops and rear animals so they can earn an income and improve their livelihood.

Though Malha manages everything responsibly, helping the aid workers’ cater to the most vulnerable households, his heart aches to return to Mali.

“When you leave your country, you lose everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is adequate, 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 pride.”