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A number of times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and permits him to monitor the wellbeing of other residents.

His first stay in Mauritania came in 1991, when he left 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 compelled him across the border.

The former math and science teacher says he feels especially sad for the young people of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the children 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 split affections: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

First established as a few thousand dwellings, Mbera now houses around 120,000 refugees, according to UNHCR. In furthermore, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government authorities say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees come across the border, running from a extremist rebellion that hijacked the Tuareg rebellion and has since left large parts 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 worrying. 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] assist almost 90,000 people with both food or cash every month to about 53,000 … and had to halt crucial nutrition programmes for hungry 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 stores, and volleyball and football programmes. Members of a parent-teacher association use megaphones to get more children signed up in school. New entrants are registered by aid workers and state agents using biometric systems.

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

Some residents have taken on new roles 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 look after those wounded by jihadist attacks and expectant mothers while also spreading awareness about educating girls.

But the camp’s needs are obvious.

“We have the desire, 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 needs 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 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 tirelessly to acquire new funding through the expansion of our funding sources.”

The meals are powered by recent donations including several thousand tonnes of rice donated by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping launch self-sufficiency programmes to help refugees cultivate and raise animals so they can make money and enhance their standard of living.

Though Malha manages everything responsibly, helping the aid workers’ assist the most needy households, his heart longs 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 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.”