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Several times a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp leader healthy in mind and body, and allows him to check on the wellbeing of other occupants.

His first stay in Mauritania occurred in 1991, when he left Mali as Tuareg insurgents fought with the army in his home Timbuktu province.

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

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

“Some of the children who were born here in Mbera have never even seen Mali,” he says. “They do not know their country [and] that is painful because a refugee always has two hearts: 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 UNHCR. In furthermore, it is calculated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government representatives say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees arrive across the border, escaping a extremist rebellion that hijacked 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 supports the camp and adjacent settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now defunct USAID – have drastically cut funding this year.

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

The camp has many of the trappings 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 amplifiers to get more children signed up in school. New comers are documented by aid workers and state agents using digital identification.

Nearby, gendarmerie patrols protect the camp from the danger of fighters just a few miles from the border.

Some residents have taken on new responsibilities with gusto: 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 look after those injured by jihadist attacks and expectant mothers while also raising awareness about teaching girls.

But the camp’s requirements are obvious.

“We have the determination, we have the women, but not enough funding 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 served 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 mostly unseasoned, save for a few legumes.

“We’re still supplying school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most at-risk while working tirelessly to acquire new funding through the expansion of our support network.”

The meals are powered by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping launch self-sufficiency programmes to help refugees cultivate and rear animals so they can earn an income and improve their quality of life.

Though Malha oversees everything conscientiously, helping the aid workers’ cater to the most vulnerable households, his heart aches 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 adequate, sometimes it is not. And when it is not, you suffer.

“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 pride.”