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A number of mornings a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his dwelling since 2012. The activity keeps the 84-year-old camp leader vigorous, and allows him to assess the condition of other occupants.

His first stay in Mauritania came in 1991, when he escaped Mali as Tuareg separatists battled with the army in his native Timbuktu region.

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 deeply sympathetic 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 once visited 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 dreams of returning to one day.”

Initially conceived as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In furthermore, it is calculated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

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

Each month, thousands more refugees come across the border, fleeing a militant uprising that co-opted the Tuareg rebellion and has since left large parts of the country uncontrollable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and adjacent 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] support 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 funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a established 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 megaphones to get more children registered in school. New arrivals are processed by aid workers and state agents using fingerprint technology.

Nearby, gendarmerie patrols guard the camp from the risk of armed groups just a few miles from the border.

Some residents have taken on new duties with zeal: volunteers in the SOS Desert organisation grow crops for sale and run 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 spreading awareness about schooling girls.

But the camp’s needs are evident.

“We have the determination, we have the women, but not enough resources or supplies,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the requirements 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 cluster 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 cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most vulnerable while working relentlessly to secure new funding through the expansion of our support network.”

The meals are supported by recent contributions 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 start business programmes to help refugees grow crops and keep animals so they can earn an income and enhance their livelihood.

Though Malha manages everything responsibly, helping the aid workers’ support 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 are entirely reliant on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you endure hardship.

“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 pride.”