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Many 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 home since 2012. The exercise keeps the 84-year-old camp elder mentally and physically fit, and enables him to monitor the condition of other residents.

His first stay in Mauritania happened in 1991, when he fled Mali as Tuareg insurgents battled with the army in his home Timbuktu area.

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

The former mathematics and physics teacher says he feels deeply sympathetic for the younger 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 painful because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he longs to revisit one day.”

First established as a few thousand shelters, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In furthermore, it is estimated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

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

Each month, thousands more refugees pour in across the border, escaping a extremist rebellion that co-opted the Tuareg rebellion and has since left large parts of the country lawless. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and adjacent 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] help almost 90,000 people with both food or cash every month to about 53,000 … and had to discontinue vital 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 permanent settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football initiatives. Members of a parent-teacher association use megaphones to get more children signed up in school. New comers are registered by aid workers and state agents using biometric systems.

Nearby, police patrols secure the camp from the threat of armed groups just a few miles from the border.

Some residents have taken on new roles with enthusiasm: 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 raising awareness about teaching girls.

But the camp’s demands are evident.

“We have the determination, we have the women, but not enough financial support or supplies,” 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 served 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 beans.

“We’re still supplying school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working relentlessly to obtain new funding through the diversification of our funding sources.”

The meals are powered by recent donations including several thousand tonnes of rice supplied by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping initiate entrepreneurship programmes to help refugees grow crops and raise animals so they can generate funds and improve their livelihood.

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

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is enough, 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 self-respect.”