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A number of days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the enormous Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The exercise keeps the 84-year-old camp leader vigorous, and permits him to assess the welfare of other inhabitants.

His first stay in Mauritania occurred in 1991, when he escaped Mali as Tuareg rebels fought with the army in his home Timbuktu region.

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

The former math and science teacher says he feels especially sad for the younger residents of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their country [and] that is heartbreaking because a refugee always has split affections: one here, where he lives, and another over there, in his homeland, which he longs to revisit one day.”

First established as a few thousand huts, Mbera now houses around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In also, it is calculated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government authorities say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees pour in across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left swathes of the country lawless. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby settlements – cannot stop worrying. They have faced declining 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 food or cash every month to about 53,000 … and had to halt vital 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 established settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football activities. 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 digital identification.

Nearby, security patrols secure the camp from the danger of armed groups just a few miles from the border.

Some residents have taken on new responsibilities 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 look after those injured by jihadist attacks and expectant mothers while also promoting awareness about teaching girls.

But the camp’s needs are evident.

“We have the determination, we have the women, but not enough funding or equipment,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the requirements 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 cluster by a big tray to eat the same meal every school day – rice that is almost plain, save for a few beans.

“We’re still providing school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most vulnerable while working continuously to acquire new funding through the expansion of our support network.”

The meals are powered by recent donations including several thousand tonnes of rice provided 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 boost their standard of living.

Though Malha oversees everything responsibly, helping the aid workers’ support the most needy 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 rely solely on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you struggle.

“We appreciate 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.”