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Several days 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 activity keeps the 84-year-old camp leader vigorous, and allows him to assess the welfare of other inhabitants.

His initial stay in Mauritania occurred in 1991, when he fled Mali as Tuareg rebels clashed with the army in his native Timbuktu region.

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

The former math and science teacher says he feels especially sad for the younger people 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 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 hopes to go back to one day.”

First established as a few thousand shelters, Mbera now hosts around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In furthermore, it is calculated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government officials say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees arrive across the border, fleeing a militant uprising 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 services the camp and nearby settlements – cannot stop worrying. They have faced declining 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 nutritional aid or money every month to about 53,000 … and had to stop vital 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 long-term settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football programmes. Members of a parent-teacher association use loudspeakers to get more children enrolled in school. New arrivals are documented by aid workers and state agents using fingerprint technology.

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

Some residents have taken on new responsibilities with zeal: volunteers in the SOS Desert organisation farm produce 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 promoting awareness about schooling girls.

But the camp’s demands are clear.

“We have the determination, we have the women, but not enough resources 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 provided 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 providing school meals, staple provisions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most at-risk while working continuously to secure new funding through the broadening of our support network.”

The meals are funded by recent contributions including several thousand tonnes of rice supplied by the South Korean government – the only products in a most of the warehouses. A few donors are also helping launch business programmes to help refugees grow crops and rear animals so they can earn an income and enhance their livelihood.

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

“When you leave your country, you lose 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 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.”