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Several times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp coordinator healthy in mind and body, and enables him to check on the welfare of other residents.

His initial stay in Mauritania came in 1991, when he escaped Mali as Tuareg insurgents battled with the army in his home Timbuktu province.

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 unrest once again forced him across the border.

The former math and science teacher says he feels especially sad for the young residents 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 laid eyes on Mali,” he says. “They do not know their country [and] that is heartbreaking because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

Initially conceived as a few thousand huts, Mbera now houses around 120,000 refugees, according to UNHCR. In furthermore, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government officials say the area is the third-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees pour in across the border, running from a extremist rebellion that took over the Tuareg rebellion and has since left swathes of the country lawless. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and nearby settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now defunct USAID – have sharply reduced 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 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 characteristics of a long-term settlement, including its own bank, eight schools, a market with more than 500 stores, and volleyball and football programmes. Members of a parent-teacher association use megaphones to get more children registered in school. New comers are processed by aid workers and state agents using digital identification.

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

Some residents have adopted new responsibilities with gusto: 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 look after those wounded by jihadist attacks and pregnant women while also raising awareness about teaching girls.

But the camp’s requirements are evident.

“We have the determination, 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 requirements 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 cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to acquire new funding through the diversification of our support network.”

The meals are powered by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping initiate entrepreneurship programmes to help refugees grow crops and keep animals so they can make money and enhance their quality of life.

Though Malha supervises everything conscientiously, helping the aid workers’ cater to the most needy 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 sufficient, sometimes it is not. And when it is not, you struggle.

“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 self-respect.”