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Several days a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his dwelling since 2012. The exercise keeps the 84-year-old camp leader vigorous, and permits him to check on the wellbeing of other inhabitants.

His first stay in Mauritania came in 1991, when he escaped Mali as Tuareg insurgents battled with the army in his home Timbuktu region.

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

The former mathematics and physics teacher says he feels especially sad for the younger people of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have never even seen Mali,” he says. “They do not know their homeland [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 longs to revisit one day.”

Originally planned as a few thousand shelters, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In addition, 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 representatives say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, running from a militant uprising that took over the Tuareg rebellion and has since left swathes of the country lawless. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now ceased 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 discontinue essential nutrition programmes for hungry children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a established settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children registered in school. New arrivals are documented by aid workers and state agents using biometric systems.

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

Some residents have adopted new roles with gusto: 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 look after those wounded by jihadist attacks and expectant mothers while also promoting 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 recycle what little we have, but it is not enough for the needs 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 largely basic, save for a few legumes.

“We’re still supplying school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working continuously to obtain new funding through the broadening of our donor base.”

The meals are powered by recent gifts 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 launch entrepreneurship programmes to help refugees farm and rear animals so they can earn an income and boost their quality of life.

Though Malha manages everything dutifully, helping the aid workers’ support 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 depend only on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you suffer.

“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.”