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Several times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his dwelling since 2012. The routine keeps the 84-year-old camp leader healthy in mind and body, and allows him to monitor the welfare of other residents.

His initial stay in Mauritania came in 1991, when he escaped Mali as Tuareg insurgents clashed with the army in his home 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 fighting once again forced him across the border.

The former math and science teacher says he feels especially sad for the young residents of Mbera, which is positioned 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 dual loyalties: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

Originally planned as a few thousand huts, Mbera now houses around 120,000 refugees, according to UNHCR. In furthermore, it is approximated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government officials 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, escaping a militant uprising that hijacked the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby settlements – cannot stop worrying. They have faced shrinking resources as foreign donors – most notably the now defunct USAID – have severely slashed funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt vital nutrition programmes for hungry children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a long-term 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 loudspeakers to get more children signed up in school. New entrants are registered by aid workers and state agents using fingerprint technology.

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

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

But the camp’s needs are obvious.

“We have the desire, we have the women, but not enough resources 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 given 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 legumes.

“We’re still providing 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 needy while working tirelessly to secure new funding through the broadening of our donor base.”

The meals are powered by recent contributions including several thousand tonnes of rice supplied by the South Korean government – the only products 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 make money and enhance their quality of life.

Though Malha oversees everything dutifully, helping the aid workers’ assist the most vulnerable 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 are entirely reliant on humanitarian aid. Sometimes that aid is adequate, 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.”