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Several days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his residence since 2012. The activity keeps the 84-year-old camp elder mentally and physically fit, and permits him to monitor the condition of other residents.

His first stay in Mauritania came in 1991, when he escaped Mali as Tuareg insurgents fought with the army in his home Timbuktu area.

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 unrest once again forced him across the border.

The former mathematics and physics 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 children who were born here in Mbera have never even seen Mali,” he says. “They do not know their nation [and] that is painful because a refugee always has dual loyalties: one here, where he lives, and another over there, in his homeland, which he hopes to go back to one day.”

Initially conceived as a few thousand dwellings, Mbera now houses around 120,000 refugees, according to UNHCR. In also, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government representatives say the area is the number three human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees arrive across the border, fleeing a militant uprising that hijacked the Tuareg rebellion and has since left extensive areas of the country ungovernable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and neighbouring settlements – cannot stop being concerned. They have faced declining 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 crucial nutrition programmes for hungry children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 shops, 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, security patrols protect the camp from the danger of militants just a few miles from the border.

Some residents have taken on new roles with gusto: volunteers in the SOS Desert organisation grow crops for sale and run an anti-fire brigade putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and pregnant women while also promoting awareness about educating girls.

But the camp’s demands are evident.

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

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

The meals are funded by recent contributions including several thousand tonnes of rice donated by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping initiate entrepreneurship programmes to help refugees cultivate and raise animals so they can earn an income and improve their quality of life.

Though Malha supervises everything conscientiously, helping the aid workers’ assist the most disadvantaged 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 sufficient, sometimes it is not. And when it is not, you suffer.

“We are grateful to 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.”