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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 home since 2012. The activity keeps the 84-year-old camp coordinator healthy in mind and body, and permits him to monitor the welfare of other occupants.

His first stay in Mauritania occurred in 1991, when he left Mali as Tuareg separatists battled with the army in his native 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 fighting once again pushed him across the border.

The former math and science teacher says he feels deeply sympathetic for the young people of Mbera, which is located 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 country [and] that is heartbreaking 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.”

Initially conceived as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In addition, it is calculated that at least 154,000 refugees live 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 settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees pour in across the border, fleeing a extremist rebellion that took over the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and nearby settlements – cannot stop worrying. They have faced declining 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 nutritional aid or money every month to about 53,000 … and had to stop vital nutrition programmes for malnourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a established settlement, including its own financial institution, eight schools, a market with more than 500 shops, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children registered in school. New entrants are processed by aid workers and state agents using biometric systems.

Nearby, police patrols protect the camp from the risk of militants just a few miles from the border.

Some residents have assumed new duties with zeal: volunteers in the SOS Desert organisation grow crops for sale and run an firefighting unit 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 needs are obvious.

“We have the will, we have the women, but not enough funding or materials,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the demands 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 sit 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 offering 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 tirelessly to secure new funding through the expansion of our donor base.”

The meals are supported by recent contributions including several thousand tonnes of rice donated 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 enhance their standard of living.

Though Malha supervises everything dutifully, helping the aid workers’ support the most needy households, his heart longs 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 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.”