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Many times a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his dwelling since 2012. The routine keeps the 84-year-old camp leader healthy in mind and body, and permits him to assess the wellbeing of other residents.

His initial stay in Mauritania happened in 1991, when he escaped Mali as Tuareg rebels 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 social worker before transitioning to a teacher. Then in 2012, the Tuareg unrest once again compelled him across the border.

The former mathematics and physics teacher says he feels particularly sorry for the young residents of Mbera, which is situated 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 nation [and] that is difficult 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 hosts around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In furthermore, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government representatives say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees arrive across the border, fleeing a extremist rebellion that hijacked the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and nearby settlements – cannot stop being concerned. They have faced declining resources as foreign donors – most notably the now ceased 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 discontinue essential nutrition programmes for malnourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings 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 loudspeakers to get more children enrolled in school. New arrivals are processed by aid workers and state agents using digital identification.

Nearby, security patrols guard the camp from the risk of militants just a few miles from the border.

Some residents have taken on new duties with enthusiasm: volunteers in the SOS Desert organisation grow crops for sale and manage an blaze control team putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and pregnant women while also promoting awareness about educating girls.

But the camp’s requirements are clear.

“We have the desire, we have the women, but not enough resources or supplies,” 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 almost plain, save for a few beans.

“We’re still providing school meals, staple provisions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working relentlessly to acquire new funding through the expansion of our funding sources.”

The meals are powered by recent donations including several thousand tonnes of rice supplied by the South Korean government – the only products in a most of the warehouses. A few donors are also helping start business programmes to help refugees cultivate and keep animals so they can generate funds and enhance their livelihood.

Though Malha manages everything dutifully, helping the aid workers’ support the most disadvantaged households, his heart yearns to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is enough, 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 dignity.”