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Several days a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp elder vigorous, and permits him to monitor the condition of other inhabitants.

His first stay in Mauritania happened in 1991, when he left Mali as Tuareg rebels clashed with the army in his home Timbuktu area.

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

The former mathematics and physics teacher says he feels particularly sorry for the younger 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 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 dreams of returning to one day.”

First established as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to UNHCR. In addition, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

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

Each month, thousands more refugees arrive across the border, escaping a militant uprising that hijacked the Tuareg rebellion and has since left extensive areas of the country lawless. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and adjacent 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] assist almost 90,000 people with both nutritional aid or money 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 established settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football activities. Members of a parent-teacher association use loudspeakers to get more children enrolled in school. New entrants are registered by aid workers and state agents using fingerprint technology.

Nearby, security patrols protect the camp from the risk of fighters just a few miles from the border.

Some residents have adopted new roles with zeal: volunteers in the SOS Desert organisation grow crops for sale and manage an anti-fire brigade putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women 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 funding or equipment,” 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 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 largely basic, save for a few beans.

“We’re still supplying school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most at-risk while working tirelessly to obtain new funding through the diversification of our funding sources.”

The meals are supported by recent contributions including several thousand tonnes of rice donated by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping start business programmes to help refugees farm and raise animals so they can make money and enhance their livelihood.

Though Malha manages everything dutifully, helping the aid workers’ cater to 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 rely solely on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you endure hardship.

“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.”