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A number of days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his dwelling since 2012. The routine keeps the 84-year-old camp leader healthy in mind and body, and enables him to monitor the welfare of other occupants.

His initial stay in Mauritania happened in 1991, when he fled Mali as Tuareg separatists clashed with the army in his native Timbuktu region.

After four years as a refugee, he came back and worked for a year as a community worker before transitioning to a teacher. Then in 2012, the Tuareg unrest once again forced him across the border.

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

“Some of the kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their country [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 longs to revisit one day.”

Originally planned as a few thousand shelters, Mbera now accommodates around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In furthermore, it is estimated 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 third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees pour in across the border, fleeing a extremist rebellion that took over the Tuareg rebellion and has since left swathes of the country lawless. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop feeling anxious. They have faced shrinking resources as foreign donors – most notably the now discontinued USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt essential nutrition programmes for undernourished 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 financial institution, eight schools, a market with more than 500 stores, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children signed up in school. New comers are registered by aid workers and state agents using biometric systems.

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

Some residents have taken on new roles with zeal: volunteers in the SOS Desert organisation cultivate food for sale and run an firefighting unit putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and expectant mothers while also promoting awareness about teaching girls.

But the camp’s needs are evident.

“We have the desire, 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 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 sit by a big tray to eat the same meal every school day – rice that is almost plain, save for a few beans.

“We’re still offering school meals, essential food aid, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working continuously to obtain new funding through the expansion 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 items in a most of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees farm and raise animals so they can generate funds and improve their quality of life.

Though Malha oversees everything responsibly, helping the aid workers’ assist the most disadvantaged 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 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 self-respect.”