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Several times 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 residence since 2012. The activity keeps the 84-year-old camp coordinator vigorous, and enables him to assess the wellbeing of other inhabitants.

His initial stay in Mauritania occurred in 1991, when he fled Mali as Tuareg insurgents fought with the army in his native Timbuktu region.

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

The former math and science teacher says he feels deeply sympathetic for the young inhabitants of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have not once visited Mali,” he says. “They do not know their nation [and] that is difficult 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.”

Originally planned as a few thousand shelters, Mbera now hosts around 120,000 refugees, according to UNHCR. In also, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government representatives say the area is the third largest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

Each month, thousands more refugees come across the border, running from a militant uprising that hijacked the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – notably at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now ceased 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 stop crucial nutrition programmes for hungry 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 initiatives. Members of a parent-teacher association use megaphones to get more children registered in school. New entrants are registered by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols protect the camp from the threat of fighters just a few miles from the border.

Some residents have adopted new duties with zeal: volunteers in the SOS Desert organisation cultivate food for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network support those wounded by jihadist attacks and expectant mothers while also promoting awareness about educating girls.

But the camp’s requirements are obvious.

“We have the determination, we have the women, but not enough financial support or equipment,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the demands 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 legumes.

“We’re still providing school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most vulnerable while working continuously to acquire new funding through the diversification of our funding sources.”

The meals are funded by recent donations 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 initiate entrepreneurship programmes to help refugees farm and rear animals so they can earn an income and boost their standard of living.

Though Malha supervises everything conscientiously, helping the aid workers’ cater to the most disadvantaged 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 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 self-respect.”