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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 home since 2012. The exercise keeps the 84-year-old camp leader vigorous, and enables him to check on the welfare of other inhabitants.

His first stay in Mauritania happened in 1991, when he fled Mali as Tuareg insurgents clashed with the army in his home Timbuktu region.

After four years as a refugee, he returned home and worked for a year as a social worker before transitioning to a teacher. Then in 2012, the Tuareg conflict once again forced him across the border.

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

“Some of the young ones who were born here in Mbera have not once visited Mali,” he says. “They do not know their nation [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 longs to revisit one day.”

Initially conceived as a few thousand dwellings, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In furthermore, it is estimated 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 administrative and commercial centers.

Each month, thousands more refugees come across the border, running from a extremist rebellion that took over the Tuareg rebellion and has since left extensive areas of the country lawless. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby settlements – cannot stop feeling anxious. They have faced declining 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 nutritional aid or money every month to about 53,000 … and had to stop essential nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a established settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football activities. Members of a parent-teacher association use loudspeakers to get more children registered in school. New arrivals are registered by aid workers and state agents using fingerprint technology.

Nearby, gendarmerie patrols protect the camp from the threat of militants just a few miles from the border.

Some residents have adopted new responsibilities with gusto: volunteers in the SOS Desert organisation grow crops for sale and run an firefighting unit putting out bushfires; members of a women’s resource network support those maimed by jihadist attacks and expectant mothers while also promoting awareness about schooling girls.

But the camp’s demands are evident.

“We have the determination, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we repurpose what little we have, but it is not enough for the demands 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 sit by a big tray to eat the same meal every school day – rice that is mostly unseasoned, 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 concentrating on the most vulnerable while working continuously to obtain new funding through the broadening of our donor base.”

The meals are powered by recent gifts including several thousand tonnes of rice provided by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping initiate self-sufficiency programmes to help refugees cultivate and rear animals so they can earn an income and enhance their livelihood.

Though Malha supervises everything dutifully, helping the aid workers’ cater to the most disadvantaged households, his heart yearns 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 enough, sometimes it is not. And when it is not, you endure hardship.

“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 dignity.”