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A number of days a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp coordinator vigorous, and enables him to check on the condition 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 region.

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 especially sad for the young people of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have never even seen Mali,” he says. “They do not know their homeland [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 hopes to go back to one day.”

First established as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to the UN refugee agency. In addition, it is approximated 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 largest human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees come across the border, running from a militant uprising that took over the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services 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] support almost 90,000 people with both food or cash every month to about 53,000 … and had to halt vital nutrition programmes for malnourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

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

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

Some residents have taken on new responsibilities with enthusiasm: volunteers in the SOS Desert organisation grow crops for sale and operate an anti-fire brigade putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and mothers-to-be while also spreading awareness about educating girls.

But the camp’s needs are clear.

“We have the desire, we have the women, but not enough funding 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 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 largely basic, save for a few pulses.

“We’re still offering school meals, basic food distributions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most vulnerable while working relentlessly to obtain new funding through the expansion of our support network.”

The meals are supported by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only items in a majority of the warehouses. A few donors are also helping initiate business programmes to help refugees farm and raise animals so they can make money and boost their livelihood.

Though Malha oversees everything responsibly, helping the aid workers’ assist the most vulnerable 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 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 pride.”