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Several 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 activity keeps the 84-year-old camp leader healthy in mind and body, and enables him to monitor the welfare of other residents.

His first stay in Mauritania occurred in 1991, when he escaped Mali as Tuareg insurgents fought with the army in his native Timbuktu region.

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

The former math and science teacher says he feels especially sad for the young people 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 nation [and] that is painful because a refugee always has split affections: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

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

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

Each month, thousands more refugees pour in across the border, escaping a militant uprising that hijacked the Tuareg rebellion and has since left extensive areas of the country ungovernable. 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 worrying. They have faced declining resources as foreign donors – most notably the now ceased USAID – have drastically cut funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to halt vital nutrition programmes for malnourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children registered in school. New arrivals are processed by aid workers and state agents using biometric systems.

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

Some residents have taken on new roles with zeal: volunteers in the SOS Desert organisation farm produce for sale and run an blaze control team putting out bushfires; members of a women’s resource network look after those maimed by jihadist attacks and expectant mothers while also raising awareness about schooling girls.

But the camp’s needs are obvious.

“We have the determination, 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 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 gather by a big tray to eat the same meal every school day – rice that is almost plain, save for a few legumes.

“We’re still offering school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working relentlessly to secure new funding through the broadening of our support network.”

The meals are powered by recent donations including several thousand tonnes of rice supplied 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 grow crops and keep animals so they can generate funds and boost their quality of life.

Though Malha supervises everything dutifully, helping the aid workers’ support the most disadvantaged households, his heart yearns to return to Mali.

“When you leave your country, you sacrifice 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 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 pride.”