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Many mornings a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The activity keeps the 84-year-old camp elder mentally and physically fit, and enables him to monitor the wellbeing of other inhabitants.

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

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

The former mathematics and physics teacher says he feels deeply sympathetic for the young people 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 country [and] that is difficult 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.”

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

Government officials say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial 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 extensive areas 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 nearby settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now defunct USAID – have severely slashed funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt 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 features of a permanent settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football activities. Members of a parent-teacher association use loudspeakers to get more children registered in school. New entrants are processed by aid workers and state agents using biometric systems.

Nearby, security patrols secure the camp from the threat of militants just a few miles from the border.

Some residents have assumed new responsibilities with zeal: volunteers in the SOS Desert organisation farm produce for sale and run an firefighting unit putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women while also promoting awareness about educating girls.

But the camp’s requirements are obvious.

“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 served one meal daily by WFP. At one school with 100 children per class, six or seven of them sit 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, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working relentlessly to acquire new funding through the diversification of our donor base.”

The meals are powered by recent donations including several thousand tonnes of rice provided by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping launch business programmes to help refugees farm and rear animals so they can make money and enhance their standard of living.

Though Malha oversees everything responsibly, helping the aid workers’ cater to the most needy 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 suffer.

“We are grateful to 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.”