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Several times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The routine keeps the 84-year-old camp leader mentally and physically fit, and allows him to monitor the wellbeing of other inhabitants.

His initial stay in Mauritania happened in 1991, when he escaped Mali as Tuareg separatists clashed with the army in his native Timbuktu province.

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

The former math and science teacher says he feels deeply sympathetic for the younger residents 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 homeland [and] that is heartbreaking because a refugee always has two hearts: 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 dwellings, Mbera now accommodates around 120,000 refugees, according to UNHCR. In furthermore, it is approximated 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 number three human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees pour in across the border, fleeing a militant uprising that hijacked 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 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 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 stop 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 features of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football programmes. Members of a parent-teacher association use amplifiers to get more children registered in school. New comers are registered by aid workers and state agents using fingerprint technology.

Nearby, police patrols secure the camp from the risk of militants just a few miles from the border.

Some residents have taken on new duties with gusto: volunteers in the SOS Desert organisation farm produce for sale and manage an blaze control team putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and expectant mothers while also raising awareness about schooling girls.

But the camp’s needs are obvious.

“We have the determination, we have the women, but not enough financial support or supplies,” a leading member of the network says. “Sometimes we repurpose what little we have, but it is not enough for the demands 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 cluster 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 at-risk while working tirelessly to acquire new funding through the expansion of our support network.”

The meals are supported by recent donations including several thousand tonnes of rice provided by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping start entrepreneurship programmes to help refugees cultivate and rear animals so they can make money and improve their livelihood.

Though Malha oversees everything dutifully, helping the aid workers’ cater to the most needy households, his heart aches to return to Mali.

“When you leave your country, you lose everything – your work, your home, your family sometimes,” he says. “Here, you depend only on humanitarian aid. Sometimes that aid is adequate, 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 pride.”