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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 south-eastern Mauritania that has been his residence since 2012. The exercise keeps the 84-year-old camp coordinator vigorous, and allows him to monitor the condition of other residents.

His initial stay in Mauritania happened in 1991, when he escaped Mali as Tuareg insurgents battled with the army in his home 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 conflict once again forced him across the border.

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

“Some of the kids who were born here in Mbera have not once visited Mali,” he says. “They do not know their country [and] that is painful because a refugee always has two hearts: 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 houses 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 region. More than half are under 18.

Government authorities say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business capitals.

Each month, thousands more refugees arrive across the border, fleeing a militant uprising that co-opted the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and neighbouring settlements – cannot stop being concerned. They have faced declining resources as foreign donors – most notably the now defunct USAID – have severely slashed 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 discontinue crucial nutrition programmes for undernourished children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a permanent 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 registered by aid workers and state agents using digital identification.

Nearby, security patrols guard the camp from the threat of militants just a few miles from the border.

Some residents have taken on new responsibilities with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and run an blaze control team putting out bushfires; members of a women’s resource network care for those injured by jihadist attacks and expectant mothers while also promoting awareness about educating girls.

But the camp’s requirements are evident.

“We have the determination, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we repurpose 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 gather by a big tray to eat the same meal every school day – rice that is almost plain, save for a few beans.

“We’re still offering school meals, basic food distributions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most vulnerable while working tirelessly to obtain new funding through the expansion of our funding sources.”

The meals are supported by recent gifts including several thousand tonnes of rice provided by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees grow crops and keep animals so they can make money and boost their livelihood.

Though Malha oversees everything dutifully, helping the aid workers’ assist the most vulnerable 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 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 self-respect.”