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A number of mornings 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 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 inhabitants.

His initial stay in Mauritania happened in 1991, when he fled Mali as Tuareg rebels fought with the army in his home Timbuktu province.

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

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

“Some of the young ones who were born here in Mbera have never even seen Mali,” he says. “They do not know their nation [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 accommodates around 120,000 refugees, according to the UN refugee agency. In also, it is calculated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

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

Each month, thousands more refugees pour in across the border, fleeing a militant uprising that took over 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 supports the camp and adjacent settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now ceased USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to stop essential nutrition programmes for malnourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 outlets, 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 digital identification.

Nearby, police patrols secure the camp from the risk of fighters just a few miles from the border.

Some residents have adopted new roles with zeal: volunteers in the SOS Desert organisation cultivate food for sale and run an firefighting unit putting out bushfires; members of a women’s resource network support those wounded by jihadist attacks and mothers-to-be while also raising awareness about schooling girls.

But the camp’s needs are evident.

“We have the desire, we have the women, but not enough resources or materials,” 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 served one meal daily by WFP. At one school with 100 children per class, six or seven of them cluster 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 supplying school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working continuously to secure new funding through the diversification of our support network.”

The meals are supported by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping initiate business programmes to help refugees cultivate and raise animals so they can generate funds and boost their quality of life.

Though Malha manages everything conscientiously, helping the aid workers’ support the most disadvantaged households, his heart aches to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you rely solely 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 self-respect.”