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A number of mornings a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his residence since 2012. The exercise keeps the 84-year-old camp elder mentally and physically fit, and enables him to monitor the condition of other residents.

His initial stay in Mauritania happened in 1991, when he escaped Mali as Tuareg insurgents fought 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 becoming a teacher. Then in 2012, the Tuareg fighting once again pushed him across the border.

The former math and science teacher says he feels particularly sorry for the younger inhabitants of Mbera, which is located 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 painful because a refugee always has dual loyalties: 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 dwellings, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In also, it is approximated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government authorities say the area is the third largest human community in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees arrive across the border, running from a extremist rebellion that hijacked the Tuareg rebellion and has since left swathes of the country uncontrollable. 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 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 discontinue crucial 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 permanent 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 signed up in school. New comers are processed by aid workers and state agents using biometric systems.

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

Some residents have taken on new responsibilities with gusto: volunteers in the SOS Desert organisation grow crops for sale and operate an firefighting unit putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and pregnant women while also promoting awareness about schooling girls.

But the camp’s needs are evident.

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

“We’re still supplying school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most vulnerable while working continuously to acquire new funding through the expansion of our funding sources.”

The meals are funded by recent contributions including several thousand tonnes of rice supplied by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping initiate business programmes to help refugees grow crops and raise animals so they can earn an income and improve their quality of life.

Though Malha supervises everything dutifully, helping the aid workers’ assist the most disadvantaged households, his heart yearns to return to Mali.

“When you leave your country, you lose 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 suffer.

“We thank 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.”