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Many days a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the enormous Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and enables him to assess the condition of other occupants.

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

The former math and science 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 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.”

Initially conceived 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 reside in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government officials say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees pour in across the border, running from a extremist rebellion that took over the Tuareg rebellion and has since left large parts of the country lawless. 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 defunct USAID – have drastically cut funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to halt vital 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 established settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children enrolled in school. New entrants are processed by aid workers and state agents using biometric systems.

Nearby, security patrols secure the camp from the danger of militants just a few miles from the border.

Some residents have assumed new responsibilities with gusto: volunteers in the SOS Desert organisation grow crops for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network support those maimed by jihadist attacks and expectant mothers while also raising awareness about educating girls.

But the camp’s demands are obvious.

“We have the will, we have the women, but not enough funding or materials,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the demands 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 largely basic, save for a few pulses.

“We’re still offering school meals, essential food aid, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working relentlessly to obtain new funding through the expansion of our funding sources.”

The meals are funded by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees farm and keep animals so they can earn an income and improve their livelihood.

Though Malha supervises everything dutifully, helping the aid workers’ support the most needy 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 depend only 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.”