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Several 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 home since 2012. The exercise keeps the 84-year-old camp elder mentally and physically fit, and allows him to monitor the condition of other inhabitants.

His first stay in Mauritania came in 1991, when he fled Mali as Tuareg rebels fought with the army in his native Timbuktu region.

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 fighting once again forced him across the border.

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

“Some of the children 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 split affections: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

Initially conceived as a few thousand dwellings, Mbera now accommodates around 120,000 refugees, according to UNHCR. In furthermore, it is estimated that at least 154,000 refugees reside 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 community 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 co-opted the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – notably 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 discontinued USAID – have sharply reduced 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 stop crucial nutrition programmes for hungry children and mothers due to budget reductions,” 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 megaphones to get more children registered in school. New entrants are documented by aid workers and state agents using biometric systems.

Nearby, police patrols guard the camp from the risk of militants just a few miles from the border.

Some residents have assumed new duties with enthusiasm: volunteers in the SOS Desert organisation cultivate food for sale and manage an anti-fire brigade putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and mothers-to-be while also raising awareness about teaching girls.

But the camp’s demands are clear.

“We have the determination, 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 demands 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 gather by a big tray to eat the same meal every school day – rice that is mostly unseasoned, save for a few beans.

“We’re still providing school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most needy while working continuously to obtain new funding through the broadening of our support network.”

The meals are powered by recent contributions including several thousand tonnes of rice supplied by the South Korean government – the only items in a bulk of the warehouses. A few donors are also helping initiate self-sufficiency programmes to help refugees cultivate and raise animals so they can make money and improve their standard of living.

Though Malha manages everything conscientiously, helping the aid workers’ assist the most needy households, his heart aches to return to Mali.

“When you leave your country, you lose 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 suffer.

“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.”