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A number of mornings a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his dwelling since 2012. The routine keeps the 84-year-old camp elder mentally and physically fit, and permits him to monitor the wellbeing of other residents.

His initial stay in Mauritania came in 1991, when he escaped Mali as Tuareg separatists clashed with the army in his home Timbuktu area.

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

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

“Some of the kids who were born here in Mbera have not once visited 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.”

Originally planned as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In also, it is approximated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

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

Each month, thousands more refugees come across the border, escaping a extremist rebellion that hijacked the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and adjacent settlements – cannot stop worrying. They have faced shrinking resources as foreign donors – most notably the now discontinued USAID – have drastically cut funding this year.

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

The camp has many of the characteristics of a long-term settlement, including its own bank, eight schools, a market with more than 500 stores, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children enrolled in school. New comers are registered by aid workers and state agents using digital identification.

Nearby, security patrols secure the camp from the danger of militants just a few miles from the border.

Some residents have adopted new roles with gusto: volunteers in the SOS Desert organisation farm produce for sale and manage an blaze control team putting out bushfires; members of a women’s resource network look after those maimed by jihadist attacks and expectant mothers while also promoting awareness about teaching girls.

But the camp’s requirements are evident.

“We have the will, we have the women, but not enough resources or materials,” 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 cluster by a big tray to eat the same meal every school day – rice that is almost plain, save for a few legumes.

“We’re still providing school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most at-risk while working relentlessly to obtain new funding through the expansion of our support network.”

The meals are funded by recent gifts 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 farm and keep animals so they can generate funds and enhance their standard of living.

Though Malha manages everything dutifully, helping the aid workers’ cater to the most vulnerable 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 rely solely on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you struggle.

“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.”