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Many mornings 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 activity keeps the 84-year-old camp leader mentally and physically fit, and permits him to check on the welfare of other residents.

His first stay in Mauritania happened in 1991, when he left Mali as Tuareg separatists fought with the army in his home Timbuktu province.

After four years as a refugee, he returned home and worked for a year as a social worker before becoming a teacher. Then in 2012, the Tuareg unrest once again compelled him across the border.

The former math and science teacher says he feels deeply sympathetic for the young people 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 nation [and] that is painful because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he longs to revisit one day.”

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

Government authorities say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees arrive across the border, running from a militant uprising that co-opted the Tuareg rebellion and has since left large parts of the country uncontrollable. 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 dwindling resources as foreign donors – most notably the now ceased USAID – have severely slashed funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to discontinue crucial nutrition programmes for malnourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football initiatives. Members of a parent-teacher association use megaphones to get more children signed up in school. New comers are processed by aid workers and state agents using fingerprint technology.

Nearby, security patrols guard the camp from the danger of armed groups just a few miles from the border.

Some residents have taken on new responsibilities with gusto: 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 wounded by jihadist attacks and mothers-to-be while also spreading awareness about schooling girls.

But the camp’s demands are clear.

“We have the will, we have the women, but not enough financial support or supplies,” a leading member of the network says. “Sometimes we repurpose 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 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 providing school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to secure new funding through the expansion of our donor base.”

The meals are powered by recent donations including several thousand tonnes of rice provided 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 cultivate and keep animals so they can generate funds and improve their standard of living.

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

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

“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 pride.”