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

His first stay in Mauritania occurred in 1991, when he fled Mali as Tuareg separatists fought with the army in his native Timbuktu province.

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 unrest once again forced him across the border.

The former math and science teacher says he feels particularly sorry for the young people of Mbera, which is situated 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 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 shelters, Mbera now houses around 120,000 refugees, according to UNHCR. In furthermore, it is approximated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government representatives say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees arrive across the border, escaping a extremist rebellion that hijacked the Tuareg rebellion and has since left swathes of the country uncontrollable. Aid workers – especially 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 shrinking resources as foreign donors – most notably the now discontinued USAID – have severely slashed 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 vital nutrition programmes for undernourished children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a permanent settlement, including its own financial institution, 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 enrolled in school. New comers are registered by aid workers and state agents using biometric systems.

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

Some residents have taken on new duties with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and run an blaze control team putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and expectant mothers while also spreading awareness about schooling girls.

But the camp’s needs are evident.

“We have the desire, we have the women, but not enough financial support or materials,” 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 provided one meal daily by WFP. At one school with 100 children per class, six or seven of them cluster by a big tray to eat the same meal every school day – rice that is mostly unseasoned, save for a few beans.

“We’re still providing school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working relentlessly to secure new funding through the broadening of our support network.”

The meals are powered 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 keep animals so they can make money and enhance their standard of living.

Though Malha oversees everything dutifully, helping the aid workers’ support the most disadvantaged households, his heart aches to return to Mali.

“When you leave your country, you sacrifice 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 suffer.

“We are grateful to 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.”