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Several times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his dwelling since 2012. The activity keeps the 84-year-old camp leader healthy in mind and body, and allows him to monitor the condition of other inhabitants.

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

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

The former math and science teacher says he feels particularly sorry for the younger inhabitants of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have never even seen Mali,” he says. “They do not know their country [and] that is difficult 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.”

Originally planned as a few thousand dwellings, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In furthermore, it is approximated 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 settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees arrive across the border, fleeing a extremist rebellion that took over the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – especially 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 severely slashed funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt crucial nutrition programmes for undernourished children and mothers due to funding cuts,” 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 outlets, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children enrolled in school. New arrivals are registered by aid workers and state agents using biometric systems.

Nearby, security patrols guard the camp from the threat of fighters just a few miles from the border.

Some residents have adopted new duties with enthusiasm: volunteers in the SOS Desert organisation cultivate food for sale and run an blaze control team putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and mothers-to-be while also raising awareness about teaching girls.

But the camp’s needs are evident.

“We have the determination, 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 requirements 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 beans.

“We’re still offering school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working tirelessly to secure new funding through the expansion of our support network.”

The meals are powered by recent contributions including several thousand tonnes of rice donated by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees farm and raise animals so they can generate funds and boost their standard of living.

Though Malha oversees everything dutifully, 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 sufficient, 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 pride.”