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Several days a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the enormous Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The exercise keeps the 84-year-old camp elder vigorous, and enables him to check on the wellbeing of other occupants.

His first stay in Mauritania happened in 1991, when he left Mali as Tuareg insurgents fought with the army in his home Timbuktu region.

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

The former mathematics and physics teacher says he feels especially sad for the younger people of Mbera, which is located approximately 30 miles from the Malian border.

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

Originally planned as a few thousand shelters, Mbera now hosts around 120,000 refugees, according to UNHCR. In also, it is calculated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. 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 capitals.

Each month, thousands more refugees arrive across the border, running from a militant uprising that took over the Tuareg rebellion and has since left swathes of the country ungovernable. 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 being concerned. They have faced declining resources as foreign donors – most notably the now defunct USAID – have severely slashed 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 halt vital nutrition programmes for undernourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a established settlement, including its own bank, 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 signed up in school. New arrivals are registered by aid workers and state agents using fingerprint technology.

Nearby, gendarmerie patrols secure the camp from the danger of armed groups just a few miles from the border.

Some residents have assumed new duties 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 wounded by jihadist attacks and mothers-to-be while also spreading awareness about teaching girls.

But the camp’s demands are evident.

“We have the will, we have the women, but not enough resources or materials,” 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 sit by a big tray to eat the same meal every school day – rice that is almost plain, save for a few legumes.

“We’re still offering 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 continuously to secure new funding through the broadening of our donor base.”

The meals are supported by recent contributions including several thousand tonnes of rice supplied by the South Korean government – the only items in a bulk of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees grow crops and rear animals so they can earn an income and enhance their standard of living.

Though Malha supervises everything responsibly, helping the aid workers’ assist the most vulnerable 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 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.”