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Several days a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The exercise keeps the 84-year-old camp leader mentally and physically fit, and enables him to monitor the welfare of other occupants.

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

After four years as a refugee, he went back and worked for a year as a community worker before becoming a teacher. Then in 2012, the Tuareg fighting once again pushed him across the border.

The former math and science teacher says he feels deeply sympathetic for the younger people of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their homeland [and] that is heartbreaking because a refugee always has split affections: 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 dwellings, Mbera now houses around 120,000 refugees, according to UNHCR. In addition, 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 representatives 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 pour in across the border, fleeing a extremist rebellion that took over the Tuareg rebellion and has since left swathes of the country uncontrollable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and adjacent settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now defunct 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 stop 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 trappings of a permanent settlement, including its own bank, eight schools, a market with more than 500 outlets, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children signed up in school. New comers are documented by aid workers and state agents using fingerprint technology.

Nearby, gendarmerie patrols guard the camp from the threat of armed groups 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 manage an anti-fire brigade putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women while also raising awareness about schooling girls.

But the camp’s needs are clear.

“We have the determination, we have the women, but not enough resources or supplies,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the requirements of the camp.”

In the schools, the children are given 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 almost plain, save for a few legumes.

“We’re still supplying school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most at-risk while working relentlessly to secure new funding through the broadening of our support network.”

The meals are supported by recent gifts including several thousand tonnes of rice donated by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping initiate self-sufficiency programmes to help refugees farm and keep animals so they can make money and enhance their quality of life.

Though Malha oversees everything responsibly, helping the aid workers’ assist the most needy 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 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.”