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A number of days 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 allows him to check on the wellbeing of other residents.

His first stay in Mauritania came in 1991, when he fled Mali as Tuareg rebels fought 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 transitioning to a teacher. Then in 2012, the Tuareg fighting once again compelled him across the border.

The former mathematics and physics teacher says he feels particularly sorry for the young people of Mbera, which is positioned 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 homeland [and] that is difficult because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

First established as a few thousand dwellings, Mbera now hosts 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 authorities say the area is the third largest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees come 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 being concerned. They have faced shrinking 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 nutritional aid or money every month to about 53,000 … and had to stop essential nutrition programmes for malnourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football programmes. Members of a parent-teacher association use megaphones to get more children enrolled in school. New entrants are processed by aid workers and state agents using biometric systems.

Nearby, security patrols guard the camp from the risk of militants just a few miles from the border.

Some residents have assumed new responsibilities with gusto: volunteers in the SOS Desert organisation grow crops for sale and manage an blaze control team putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and expectant mothers while also raising awareness about teaching girls.

But the camp’s requirements are clear.

“We have the will, we have the women, but not enough financial support or materials,” 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 sit by a big tray to eat the same meal every school day – rice that is largely basic, save for a few pulses.

“We’re still offering school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working tirelessly to acquire new funding through the diversification of our support network.”

The meals are funded by recent donations including several thousand tonnes of rice provided by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping launch business programmes to help refugees farm and keep animals so they can make money and improve their standard of living.

Though Malha manages everything dutifully, helping the aid workers’ assist the most vulnerable households, his heart aches 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 enough, sometimes it is not. And when it is not, you struggle.

“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.”