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Many mornings a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp elder mentally and physically fit, and enables him to assess the welfare of other residents.

His first stay in Mauritania occurred in 1991, when he fled Mali as Tuareg rebels battled 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 conflict once again pushed him across the border.

The former math and science 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 kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their country [and] that is heartbreaking because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he hopes to go back to one day.”

First established as a few thousand shelters, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In also, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

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

Each month, thousands more refugees arrive across the border, escaping a extremist rebellion that hijacked the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – particularly 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 drastically cut funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt essential nutrition programmes for malnourished 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 bank, eight schools, a market with more than 500 outlets, and volleyball and football activities. Members of a parent-teacher association use loudspeakers to get more children enrolled in school. New entrants are processed by aid workers and state agents using digital identification.

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

Some residents have adopted new responsibilities with enthusiasm: volunteers in the SOS Desert organisation cultivate food for sale and run an anti-fire brigade putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and mothers-to-be while also promoting awareness about educating girls.

But the camp’s demands are obvious.

“We have the will, we have the women, but not enough resources or materials,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the requirements 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 cluster 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 supplying school meals, staple provisions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to obtain new funding through the diversification of our funding sources.”

The meals are funded by recent donations including several thousand tonnes of rice provided by the South Korean government – the only items in a majority of the warehouses. A few donors are also helping launch business programmes to help refugees grow crops and rear animals so they can earn an income and enhance their quality of life.

Though Malha manages everything responsibly, helping the aid workers’ support the most disadvantaged households, his heart longs to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you depend only on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you endure hardship.

“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 pride.”