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A number of 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 exercise keeps the 84-year-old camp elder healthy in mind and body, and permits him to check on the welfare of other residents.

His initial stay in Mauritania happened in 1991, when he left Mali as Tuareg insurgents battled with the army in his native Timbuktu region.

After four years as a refugee, he returned home and worked for a year as a community worker before transitioning to a teacher. Then in 2012, the Tuareg conflict once again compelled him across the border.

The former math and science 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 kids who were born here in Mbera have not once visited Mali,” he says. “They do not know their homeland [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 hopes to go back to one day.”

Initially conceived as a few thousand shelters, Mbera now houses around 120,000 refugees, according to UNHCR. In addition, 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 capitals.

Each month, thousands more refugees come across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left large parts of the country lawless. Aid workers – particularly 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 shrinking resources as foreign donors – most notably the now defunct USAID – have drastically cut funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both food or cash every month to about 53,000 … and had to discontinue crucial nutrition programmes for malnourished 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 financial institution, 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 documented by aid workers and state agents using fingerprint technology.

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

Some residents have adopted new roles with gusto: volunteers in the SOS Desert organisation grow crops for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and expectant mothers while also promoting awareness about educating girls.

But the camp’s demands are clear.

“We have the will, we have the women, but not enough financial support or supplies,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the needs 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 almost plain, save for a few legumes.

“We’re still providing school meals, essential food aid, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most vulnerable while working relentlessly to secure new funding through the broadening 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 items in a most of the warehouses. A few donors are also helping initiate business programmes to help refugees grow crops and keep animals so they can earn an income and boost their standard of living.

Though Malha supervises everything conscientiously, helping the aid workers’ support the most vulnerable households, his heart aches to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you depend only 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 pride.”