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Several times 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 home since 2012. The exercise keeps the 84-year-old camp elder vigorous, and allows him to assess the welfare of other occupants.

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

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

The former math and science teacher says he feels especially sad for the young residents of Mbera, which is located 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 heartbreaking 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 huts, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In furthermore, 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 authorities say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees pour in across the border, fleeing a militant uprising that co-opted the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and neighbouring settlements – cannot stop being concerned. They have faced declining resources as foreign donors – most notably the now ceased USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to stop 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 characteristics of a long-term settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children signed up in school. New arrivals are processed by aid workers and state agents using digital identification.

Nearby, police patrols secure the camp from the danger 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 operate an anti-fire brigade putting out bushfires; members of a women’s resource network look after those maimed by jihadist attacks and expectant mothers while also raising awareness about teaching girls.

But the camp’s needs are evident.

“We have the will, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the needs of the camp.”

In the schools, the children are given 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 largely basic, save for a few legumes.

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

The meals are funded by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping start business programmes to help refugees cultivate and rear animals so they can generate funds and boost 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 sacrifice everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is sufficient, 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 dignity.”