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Several times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his dwelling since 2012. The exercise keeps the 84-year-old camp leader healthy in mind and body, and enables him to assess the condition of other residents.

His first stay in Mauritania happened in 1991, when he left Mali as Tuareg rebels fought with the army in his native Timbuktu region.

After four years as a refugee, he came back and worked for a year as a social worker before transitioning to a teacher. Then in 2012, the Tuareg unrest once again compelled him across the border.

The former mathematics and physics teacher says he feels deeply sympathetic for the younger inhabitants of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their homeland [and] that is heartbreaking because a refugee always has dual loyalties: 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 dwellings, Mbera now accommodates around 120,000 refugees, according to UNHCR. In addition, it is calculated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

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

Each month, thousands more refugees arrive across the border, running from a militant uprising that co-opted the Tuareg rebellion and has since left swathes 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 nearby settlements – cannot stop being concerned. They have faced shrinking 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 halt essential nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a long-term settlement, including its own bank, eight schools, a market with more than 500 outlets, and volleyball and football programmes. Members of a parent-teacher association use megaphones to get more children enrolled in school. New comers are processed by aid workers and state agents using biometric systems.

Nearby, security patrols protect the camp from the threat of militants just a few miles from the border.

Some residents have taken on new responsibilities with gusto: volunteers in the SOS Desert organisation farm produce for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and mothers-to-be while also spreading awareness about educating girls.

But the camp’s needs are evident.

“We have the will, we have the women, but not enough financial support or equipment,” 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 given 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 mostly unseasoned, save for a few legumes.

“We’re still providing school meals, staple provisions, 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 secure new funding through the diversification of our support network.”

The meals are powered by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping initiate business programmes to help refugees cultivate and keep animals so they can earn an income and improve their quality of life.

Though Malha supervises everything responsibly, helping the aid workers’ support the most vulnerable 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 are entirely reliant on humanitarian aid. Sometimes that aid is sufficient, 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 self-respect.”