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Many times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The exercise keeps the 84-year-old camp elder vigorous, and allows him to check on the condition of other residents.

His first stay in Mauritania came in 1991, when he fled Mali as Tuareg insurgents clashed with the army in his native Timbuktu area.

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 fighting once again pushed him across the border.

The former math and science teacher says he feels particularly sorry for the young inhabitants 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 once visited 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.”

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

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

Each month, thousands more refugees pour in across the border, fleeing a militant uprising that took over the Tuareg rebellion and has since left large parts of the country uncontrollable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and adjacent settlements – cannot stop being concerned. They have faced declining resources as foreign donors – most notably the now ceased USAID – have severely slashed funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to discontinue vital nutrition programmes for undernourished children and mothers due to financial constraints,” 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 activities. Members of a parent-teacher association use megaphones to get more children enrolled in school. New comers are registered by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols guard the camp from the threat of fighters just a few miles from the border.

Some residents have taken on new roles with enthusiasm: volunteers in the SOS Desert organisation grow crops 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 pregnant women while also promoting awareness about schooling girls.

But the camp’s needs are obvious.

“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 demands 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 mostly unseasoned, save for a few pulses.

“We’re still providing school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to acquire new funding through the expansion of our support network.”

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 start business programmes to help refugees farm and raise animals so they can generate funds and boost their standard of living.

Though Malha manages everything responsibly, helping the aid workers’ assist the most vulnerable households, his heart yearns to return to Mali.

“When you leave your country, you lose everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is enough, sometimes it is not. And when it is not, you struggle.

“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.”