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Many times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The activity keeps the 84-year-old camp leader mentally and physically fit, and enables him to assess the wellbeing of other inhabitants.

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

After four years as a refugee, he came back and worked for a year as a social worker before becoming a teacher. Then in 2012, the Tuareg conflict once again pushed him across the border.

The former mathematics and physics teacher says he feels especially sad for the younger residents of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have not once visited Mali,” he says. “They do not know their nation [and] that is difficult 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.”

Initially conceived as a few thousand dwellings, Mbera now accommodates around 120,000 refugees, according to UNHCR. In also, it is calculated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

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

Each month, thousands more refugees come across the border, fleeing 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 supports the camp and adjacent settlements – cannot stop being concerned. They have faced dwindling resources as foreign donors – most notably the now ceased USAID – have sharply reduced 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 stop crucial nutrition programmes for hungry children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football initiatives. Members of a parent-teacher association use megaphones to get more children signed up in school. New comers are documented by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols guard the camp from the danger of fighters just a few miles from the border.

Some residents have assumed new roles with enthusiasm: 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 support those maimed by jihadist attacks and mothers-to-be while also promoting awareness about educating girls.

But the camp’s demands are clear.

“We have the determination, we have the women, but not enough resources or supplies,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the demands 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 gather by a big tray to eat the same meal every school day – rice that is largely basic, save for a few legumes.

“We’re still providing school meals, essential food aid, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working relentlessly to secure new funding through the expansion of our support network.”

The meals are supported by recent donations including several thousand tonnes of rice provided by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees farm and rear animals so they can generate funds and boost their standard of living.

Though Malha supervises everything responsibly, helping the aid workers’ cater to the most vulnerable households, his heart yearns to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you suffer.

“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.”