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A number of times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The exercise keeps the 84-year-old camp elder vigorous, and permits him to monitor the welfare of other residents.

His first stay in Mauritania occurred in 1991, when he left 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 community 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 young people of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have not once visited Mali,” he says. “They do not know their country [and] that is difficult 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 accommodates around 120,000 refugees, according to UNHCR. In addition, it is approximated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government officials say the area is the number three human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees arrive across the border, running from a extremist rebellion that co-opted 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 neighbouring settlements – cannot stop feeling anxious. They have faced shrinking resources as foreign donors – most notably the now ceased USAID – have sharply reduced 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 malnourished children and mothers due to financial constraints,” 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 stores, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children signed up in school. New arrivals are documented by aid workers and state agents using biometric systems.

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

Some residents have adopted new roles with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and operate an anti-fire brigade putting out bushfires; members of a women’s resource network look after those maimed by jihadist attacks and pregnant women while also raising awareness about educating girls.

But the camp’s requirements are evident.

“We have the will, we have the women, but not enough financial support or equipment,” 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 provided 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 mostly unseasoned, save for a few beans.

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

The meals are supported by recent gifts including several thousand tonnes of rice donated by the South Korean government – the only products in a most of the warehouses. A few donors are also helping launch business programmes to help refugees grow crops and rear animals so they can make money and enhance their livelihood.

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

“When you leave your country, you forfeit 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.”