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

His initial stay in Mauritania came in 1991, when he left Mali as Tuareg insurgents clashed with the army in his home Timbuktu province.

After four years as a refugee, he went back and worked for a year as a social worker before becoming a teacher. Then in 2012, the Tuareg unrest once again pushed him across the border.

The former math and science teacher says he feels particularly sorry for the young inhabitants of Mbera, which is situated 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 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.”

Originally planned as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In also, it is approximated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government officials say the area is the third-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees come across the border, escaping a extremist rebellion that took over the Tuareg rebellion and has since left swathes of the country uncontrollable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and neighbouring settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now discontinued USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to discontinue essential nutrition programmes for malnourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football programmes. Members of a parent-teacher association use amplifiers to get more children signed up in school. New entrants are documented by aid workers and state agents using fingerprint technology.

Nearby, security patrols guard the camp from the threat of fighters just a few miles from the border.

Some residents have adopted new responsibilities with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and run an anti-fire brigade putting out bushfires; members of a women’s resource network support those maimed by jihadist attacks and mothers-to-be while also promoting awareness about schooling girls.

But the camp’s requirements are clear.

“We have the determination, 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 needs of the camp.”

In the schools, the children are served 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 legumes.

“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 concentrating on the most vulnerable while working relentlessly to acquire new funding through the broadening of our donor base.”

The meals are funded by recent contributions 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 launch self-sufficiency programmes to help refugees farm and rear animals so they can make money and enhance their livelihood.

Though Malha supervises everything conscientiously, helping the aid workers’ assist the most vulnerable households, his heart longs 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 enough, 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 dignity.”