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Several times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp elder vigorous, and enables him to monitor the condition of other inhabitants.

His initial stay in Mauritania came in 1991, when he fled Mali as Tuareg insurgents battled with the army in his native Timbuktu region.

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 pushed him across the border.

The former mathematics and physics teacher says he feels especially sad for the younger people of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have not once visited Mali,” he says. “They do not know their nation [and] that is painful because a refugee always has dual loyalties: one here, where he lives, and another over there, in his homeland, which he hopes to go back to one day.”

Originally planned as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In addition, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

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

Each month, thousands more refugees come across the border, escaping a extremist rebellion that took over the Tuareg rebellion and has since left extensive areas of the country uncontrollable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and adjacent settlements – cannot stop being concerned. They have faced shrinking resources as foreign donors – most notably the now discontinued 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 discontinue essential nutrition programmes for undernourished 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 financial institution, 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 comers are documented by aid workers and state agents using digital identification.

Nearby, police patrols secure the camp from the threat of fighters just a few miles from the border.

Some residents have assumed new roles with enthusiasm: 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 care for those maimed by jihadist attacks and expectant mothers while also promoting awareness about teaching girls.

But the camp’s needs are clear.

“We have the will, we have the women, but not enough funding or equipment,” a leading member of the network says. “Sometimes we repurpose what little we have, but it is not enough for the requirements 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 pulses.

“We’re still providing school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most vulnerable while working tirelessly to acquire new funding through the broadening of our donor base.”

The meals are supported by recent gifts including several thousand tonnes of rice donated by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping start entrepreneurship programmes to help refugees farm and raise animals so they can generate funds and boost their standard of living.

Though Malha manages everything responsibly, helping the aid workers’ cater to the most needy households, his heart yearns 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 endure hardship.

“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 self-respect.”