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

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

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 unrest once again compelled him across the border.

The former math and science teacher says he feels deeply sympathetic for the younger inhabitants of Mbera, which is located 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 nation [and] that is painful because a refugee always has dual loyalties: 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 huts, Mbera now houses around 120,000 refugees, according to UNHCR. In also, it is estimated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government officials say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, fleeing a militant uprising that hijacked the Tuareg rebellion and has since left large parts of the country lawless. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and nearby settlements – cannot stop feeling anxious. They have faced declining 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 stop crucial nutrition programmes for hungry children and mothers due to budget reductions,” 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 stores, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children registered in school. New comers are processed by aid workers and state agents using biometric systems.

Nearby, police patrols secure the camp from the risk of armed groups just a few miles from the border.

Some residents have assumed new duties with gusto: volunteers in the SOS Desert organisation grow crops for sale and manage an blaze control team putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and expectant mothers while also raising awareness about teaching girls.

But the camp’s needs are obvious.

“We have the desire, we have the women, but not enough resources or materials,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the needs 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 beans.

“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 at-risk while working continuously to obtain new funding through the expansion of our support network.”

The meals are powered by recent donations including several thousand tonnes of rice donated by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping launch self-sufficiency programmes to help refugees grow crops and raise animals so they can earn an income and boost their livelihood.

Though Malha supervises everything dutifully, helping the aid workers’ cater to the most vulnerable households, his heart aches 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 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.”