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Several days a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp leader mentally and physically fit, and permits him to assess the wellbeing of other residents.

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 came back and worked for a year as a community worker before transitioning to a teacher. Then in 2012, the Tuareg fighting once again pushed him across the border.

The former math and science teacher says he feels especially sad for the younger residents of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their homeland [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 accommodates around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In addition, it is approximated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

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

Each month, thousands more refugees arrive across the border, escaping a militant uprising that hijacked the Tuareg rebellion and has since left extensive areas of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby 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 provisions or financial assistance every month to about 53,000 … and had to discontinue crucial nutrition programmes for undernourished children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

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

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

Some residents have adopted new duties with zeal: 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 support those injured by jihadist attacks and expectant mothers while also spreading awareness about teaching girls.

But the camp’s demands are obvious.

“We have the desire, 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 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 gather 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 prioritizing the most at-risk while working relentlessly to acquire new funding through the expansion of our donor base.”

The meals are funded by recent gifts including several thousand tonnes of rice donated by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping start business programmes to help refugees grow crops and raise animals so they can earn an income and enhance their quality of life.

Though Malha supervises everything conscientiously, helping the aid workers’ assist the most disadvantaged 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 rely solely on humanitarian aid. Sometimes that aid is sufficient, 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.”