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

His initial stay in Mauritania occurred in 1991, when he fled Mali as Tuareg separatists clashed with the army in his home Timbuktu area.

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

The former mathematics and physics teacher says he feels particularly sorry for the young residents 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 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.”

First established as a few thousand huts, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In furthermore, it is calculated 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 encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, fleeing a militant uprising that co-opted 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 services the camp and nearby settlements – cannot stop feeling anxious. They have faced declining 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 nutritional aid or money every month to about 53,000 … and had to discontinue vital nutrition programmes for malnourished children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 shops, and volleyball and football programmes. Members of a parent-teacher association use loudspeakers to get more children registered in school. New comers are processed by aid workers and state agents using biometric systems.

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

Some residents have taken on new duties with zeal: volunteers in the SOS Desert organisation cultivate food for sale and run an firefighting unit putting out bushfires; members of a women’s resource network look after those injured by jihadist attacks and pregnant women while also promoting awareness about teaching girls.

But the camp’s requirements are obvious.

“We have the desire, we have the women, but not enough financial support or supplies,” 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 given one meal daily by WFP. At one school with 100 children per class, six or seven of them gather 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, staple provisions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working relentlessly to acquire new funding through the broadening of our support network.”

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 launch self-sufficiency programmes to help refugees cultivate and rear animals so they can earn an income and boost their standard of living.

Though Malha oversees everything dutifully, helping the aid workers’ support the most needy households, his heart longs to return to Mali.

“When you leave your country, you forfeit 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 endure hardship.

“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.”