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A number of mornings 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 activity keeps the 84-year-old camp elder healthy in mind and body, and allows him to check on the welfare of other residents.

His first stay in Mauritania came in 1991, when he fled Mali as Tuareg rebels clashed with the army in his home Timbuktu province.

After four years as a refugee, he returned home and worked for a year as a social 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 especially sad for the younger 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 not laid eyes on Mali,” he says. “They do not know their nation [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 longs to revisit one day.”

First established as a few thousand shelters, Mbera now accommodates around 120,000 refugees, according to UNHCR. In also, 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 representatives say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees arrive across the border, running from a extremist rebellion that co-opted the Tuareg rebellion and has since left extensive areas of the country uncontrollable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby settlements – cannot stop feeling anxious. 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] assist almost 90,000 people with both food or cash every month to about 53,000 … and had to halt essential nutrition programmes for undernourished 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 bank, eight schools, a market with more than 500 stores, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children registered in school. New entrants are registered by aid workers and state agents using fingerprint technology.

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

Some residents have taken on new roles with gusto: volunteers in the SOS Desert organisation farm produce for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and pregnant women while also raising awareness about schooling girls.

But the camp’s requirements are obvious.

“We have the desire, we have the women, but not enough resources or supplies,” 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 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 mostly unseasoned, save for a few beans.

“We’re still providing school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working relentlessly to obtain new funding through the diversification of our donor base.”

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

Though Malha oversees everything responsibly, helping the aid workers’ cater to the most vulnerable 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 adequate, sometimes it is not. And when it is not, you endure hardship.

“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 pride.”