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Many times a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his dwelling since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and permits him to check on the condition of other inhabitants.

His first stay in Mauritania happened in 1991, when he fled Mali as Tuareg separatists clashed with the army in his home Timbuktu region.

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 compelled him across the border.

The former mathematics and physics teacher says he feels deeply sympathetic for the young residents of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have never even seen 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 longs to revisit one day.”

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

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

Each month, thousands more refugees pour in across the border, fleeing a extremist rebellion that took over the Tuareg rebellion and has since left large parts of the country uncontrollable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now defunct USAID – have drastically cut funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to stop crucial nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a long-term settlement, including its own bank, eight schools, a market with more than 500 stores, and volleyball and football activities. 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 biometric systems.

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

Some residents have taken on new duties with enthusiasm: volunteers in the SOS Desert organisation grow crops for sale and operate an blaze control team putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and pregnant women while also promoting awareness about teaching girls.

But the camp’s needs are obvious.

“We have the desire, we have the women, but not enough financial support or equipment,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the requirements of the camp.”

In the schools, the children are provided 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, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most vulnerable while working continuously to acquire new funding through the expansion of our funding sources.”

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

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

“When you leave your country, you sacrifice everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is sufficient, 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.”