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A number of mornings 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 allows him to assess the welfare of other inhabitants.

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

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 mathematics and physics teacher says he feels particularly sorry for the younger residents of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have not once visited 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 hopes to go back to one day.”

Initially conceived as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In furthermore, it is calculated that at least 154,000 refugees live 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 encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business capitals.

Each month, thousands more refugees arrive across the border, escaping a extremist rebellion that hijacked the Tuareg rebellion and has since left extensive areas of the country lawless. Aid workers – especially 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 sharply reduced funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to stop 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 features of a established settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children signed up in school. New entrants are registered by aid workers and state agents using fingerprint technology.

Nearby, gendarmerie patrols secure the camp from the danger of fighters just a few miles from the border.

Some residents have adopted new duties with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and operate an blaze control team putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and pregnant women while also promoting awareness about educating girls.

But the camp’s needs are obvious.

“We have the determination, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the needs 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 largely basic, save for a few legumes.

“We’re still supplying school meals, staple provisions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most at-risk while working tirelessly to obtain new funding through the diversification of our donor base.”

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

Though Malha oversees everything responsibly, helping the aid workers’ assist the most vulnerable 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 enough, 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 dignity.”