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

His initial stay in Mauritania occurred in 1991, when he left Mali as Tuareg insurgents clashed with the army in his native Timbuktu region.

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 unrest once again forced him across the border.

The former math and science 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 never even seen Mali,” he says. “They do not know their country [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 dreams of returning to one day.”

Initially conceived as a few thousand shelters, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In addition, it is calculated that at least 154,000 refugees reside 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 governmental and business centers.

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 – 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 being concerned. They have faced dwindling resources as foreign donors – most notably the now discontinued USAID – have drastically cut 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 essential nutrition programmes for hungry children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a long-term 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 megaphones to get more children enrolled in school. New entrants are documented by aid workers and state agents using fingerprint technology.

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

Some residents have taken on new duties with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and run an blaze control team putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and mothers-to-be while also promoting awareness about schooling girls.

But the camp’s needs are obvious.

“We have the determination, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the needs 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 cluster 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 financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working tirelessly to acquire new funding through the broadening of our support network.”

The meals are powered by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only products in a most of the warehouses. A few donors are also helping launch business programmes to help refugees cultivate and rear animals so they can generate funds and boost their standard of living.

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 rely solely on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you suffer.

“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 self-respect.”