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Several mornings a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The exercise keeps the 84-year-old camp elder healthy in mind and body, and allows him to check on the condition of other residents.

His initial stay in Mauritania happened in 1991, when he escaped Mali as Tuareg separatists fought with the army in his home Timbuktu province.

After four years as a refugee, he came back and worked for a year as a community 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 deeply sympathetic for the younger residents of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have not once visited Mali,” he says. “They do not know their country [and] that is difficult because a refugee always has two hearts: 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 United Nations High Commissioner for Refugees. In furthermore, it is calculated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government representatives say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees arrive across the border, escaping a militant uprising that co-opted the Tuareg rebellion and has since left extensive areas of the country uncontrollable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop being concerned. They have faced shrinking resources as foreign donors – most notably the now defunct USAID – have severely slashed 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 discontinue essential 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 enrolled in school. New entrants are documented by aid workers and state agents using fingerprint technology.

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

Some residents have adopted new duties with gusto: volunteers in the SOS Desert organisation cultivate food for sale and operate an blaze control team putting out bushfires; members of a women’s resource network look after those injured by jihadist attacks and pregnant women while also spreading awareness about teaching girls.

But the camp’s demands are clear.

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

“We’re still offering 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 vulnerable while working continuously to obtain new funding through the diversification of our support network.”

The meals are supported by recent donations including several thousand tonnes of rice provided by the South Korean government – the only items in a most of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees farm and raise animals so they can make money and boost their livelihood.

Though Malha supervises everything responsibly, helping the aid workers’ assist the most disadvantaged households, his heart aches to return to Mali.

“When you leave your country, you sacrifice everything – your work, your home, your family sometimes,” he says. “Here, you depend only 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 self-respect.”