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

His initial stay in Mauritania occurred in 1991, when he left Mali as Tuareg rebels clashed 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 transitioning to a teacher. Then in 2012, the Tuareg conflict once again compelled him across the border.

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

“Some of the young ones who were born here in Mbera have not once visited Mali,” he says. “They do not know their nation [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.”

Originally planned as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to UNHCR. In furthermore, it is estimated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government officials say the area is the third largest human community in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees pour in across the border, fleeing a militant uprising that co-opted the Tuareg rebellion and has since left extensive areas 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 neighbouring 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] 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 financial constraints,” 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 outlets, and volleyball and football activities. Members of a parent-teacher association use amplifiers to get more children registered in school. New entrants are processed by aid workers and state agents using fingerprint technology.

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

Some residents have assumed new responsibilities with enthusiasm: volunteers in the SOS Desert organisation grow crops for sale and operate an firefighting unit putting out bushfires; members of a women’s resource network support those injured by jihadist attacks and expectant mothers while also raising awareness about teaching girls.

But the camp’s demands are clear.

“We have the will, we have the women, but not enough funding or equipment,” 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 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 mostly unseasoned, save for a few beans.

“We’re still supplying school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working relentlessly to acquire new funding through the diversification of our funding sources.”

The meals are supported by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees farm and raise animals so they can earn an income and enhance their standard of living.

Though Malha manages everything responsibly, helping the aid workers’ cater to the most disadvantaged 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 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 pride.”