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Several mornings a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp elder vigorous, and enables him to check on the welfare of other occupants.

His first stay in Mauritania happened in 1991, when he fled Mali as Tuareg separatists clashed with the army in his native Timbuktu province.

After four years as a refugee, he returned home and worked for a year as a social worker before becoming a teacher. Then in 2012, the Tuareg fighting once again pushed him across the border.

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

“Some of the children who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their homeland [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 hopes to go back to one day.”

First established as a few thousand huts, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In addition, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government authorities say the area is the third largest human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees arrive across the border, escaping a extremist rebellion that co-opted the Tuareg rebellion and has since left large parts of the country lawless. Aid workers – especially 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 discontinued USAID – have severely slashed 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 funding cuts,” says Aliou Diongue, country director for WFP.

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

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

Some residents have assumed new duties with zeal: volunteers in the SOS Desert organisation cultivate food for sale and operate an anti-fire brigade putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and expectant mothers while also spreading awareness about educating girls.

But the camp’s demands are clear.

“We have the will, we have the women, but not enough resources or materials,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the demands 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 gather by a big tray to eat the same meal every school day – rice that is mostly unseasoned, save for a few pulses.

“We’re still supplying school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working relentlessly to secure new funding through the broadening of our donor base.”

The meals are supported by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping launch self-sufficiency programmes to help refugees farm and raise animals so they can make money and boost their standard of living.

Though Malha manages everything conscientiously, helping the aid workers’ assist 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 rely solely on humanitarian aid. Sometimes that aid is enough, 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 dignity.”