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Several times 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 home since 2012. The routine keeps the 84-year-old camp leader vigorous, and permits him to assess the welfare of other inhabitants.

His initial stay in Mauritania occurred in 1991, when he fled Mali as Tuareg separatists battled with the army in his home Timbuktu region.

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

The former mathematics and physics teacher says he feels particularly sorry for the young residents of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have never even seen Mali,” he says. “They do not know their homeland [and] that is painful 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.”

Initially conceived as a few thousand shelters, Mbera now houses around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In furthermore, it is calculated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government representatives say the area is the number three human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees come across the border, escaping a militant uprising that co-opted the Tuareg rebellion and has since left extensive areas of the country lawless. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby settlements – cannot stop being concerned. They have faced dwindling 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 nutritional aid or money every month to about 53,000 … and had to halt crucial nutrition programmes for malnourished 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 financial institution, eight schools, a market with more than 500 outlets, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children signed up in school. New entrants are processed by aid workers and state agents using biometric systems.

Nearby, police patrols secure the camp from the threat of fighters just a few miles from the border.

Some residents have taken on new responsibilities with gusto: volunteers in the SOS Desert organisation farm produce for sale and operate an anti-fire brigade putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and mothers-to-be while also spreading awareness about educating girls.

But the camp’s demands are evident.

“We have the desire, we have the women, but not enough resources or materials,” a leading member of the network says. “Sometimes we repurpose what little we have, but it is not enough for the needs 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 sit by a big tray to eat the same meal every school day – rice that is almost plain, save for a few pulses.

“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 at-risk while working tirelessly to acquire new funding through the broadening of our donor base.”

The meals are funded by recent donations including several thousand tonnes of rice donated by the South Korean government – the only items in a majority of the warehouses. A few donors are also helping launch self-sufficiency programmes to help refugees farm and rear animals so they can earn an income and boost their standard of living.

Though Malha oversees everything dutifully, helping the aid workers’ assist the most needy 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 are entirely reliant on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you suffer.

“We appreciate 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.”