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Several days a week, Mohamed ‘Momo’ Ag Malha treks 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 healthy in mind and body, and enables him to assess the condition of other residents.

His first stay in Mauritania came in 1991, when he left Mali as Tuareg rebels battled with the army in his native Timbuktu area.

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

The former mathematics and physics teacher says he feels deeply sympathetic for the younger residents of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have never even seen Mali,” he says. “They do not know their nation [and] that is heartbreaking 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 dwellings, Mbera now hosts around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In also, 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 third-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees arrive across the border, escaping a militant uprising that hijacked the Tuareg rebellion and has since left swathes of the country uncontrollable. Aid workers – notably 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 dwindling resources as foreign donors – most notably the now ceased USAID – have severely slashed 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 halt essential nutrition programmes for undernourished 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 stores, and volleyball and football initiatives. Members of a parent-teacher association use megaphones to get more children enrolled in school. New entrants are documented by aid workers and state agents using biometric systems.

Nearby, police patrols guard the camp from the danger of militants just a few miles from the border.

Some residents have adopted new responsibilities with gusto: volunteers in the SOS Desert organisation cultivate food for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and expectant mothers while also spreading awareness about teaching 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 demands of the camp.”

In the schools, the children are given 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 pulses.

“We’re still providing school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working tirelessly to secure new funding through the broadening of our funding sources.”

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 initiate self-sufficiency programmes to help refugees cultivate and rear animals so they can earn an income and enhance their standard of living.

Though Malha manages everything conscientiously, helping the aid workers’ support the most needy households, his heart yearns 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 enough, sometimes it is not. And when it is not, you endure hardship.

“We thank 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.”