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Several mornings a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his residence since 2012. The exercise keeps the 84-year-old camp leader healthy in mind and body, and allows him to monitor the welfare of other residents.

His first stay in Mauritania came in 1991, when he escaped Mali as Tuareg insurgents fought 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 conflict once again forced him across the border.

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

“Some of the kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their country [and] that is painful 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 accommodates around 120,000 refugees, according to UNHCR. In also, it is approximated 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 number three human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees pour in across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left swathes of the country uncontrollable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and adjacent settlements – cannot stop being concerned. They have faced declining resources as foreign donors – most notably the now discontinued USAID – have drastically cut 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 stop 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 long-term settlement, including its own financial institution, eight schools, a market with more than 500 shops, and volleyball and football programmes. Members of a parent-teacher association use amplifiers to get more children signed up in school. New arrivals are processed by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols protect the camp from the risk of fighters just a few miles from the border.

Some residents have taken on new duties with zeal: volunteers in the SOS Desert organisation farm produce for sale and operate 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 promoting awareness about educating girls.

But the camp’s requirements are evident.

“We have the will, we have the women, but not enough funding 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 served 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 supplying school meals, essential food aid, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working tirelessly to secure new funding through the diversification of our donor base.”

The meals are powered by recent gifts 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 entrepreneurship programmes to help refugees grow crops and keep animals so they can earn an income and improve their standard of living.

Though Malha oversees everything responsibly, helping the aid workers’ cater to the most needy households, his heart yearns to return to Mali.

“When you leave your country, you forfeit 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 endure hardship.

“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 pride.”