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Several mornings 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 residence since 2012. The routine keeps the 84-year-old camp coordinator mentally and physically fit, and allows him to monitor the welfare of other inhabitants.

His first stay in Mauritania happened in 1991, when he escaped Mali as Tuareg separatists clashed with the army in his home Timbuktu area.

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 forced him across the border.

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

“Some of the young ones who were born here in Mbera have never even seen Mali,” he says. “They do not know their nation [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 longs to revisit one day.”

Initially conceived as a few thousand shelters, Mbera now accommodates around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In addition, it is approximated that at least 154,000 refugees live in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government officials say the area is the third largest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business capitals.

Each month, thousands more refugees come across the border, escaping a extremist rebellion 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 supports the camp and adjacent settlements – cannot stop worrying. They have faced shrinking 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 discontinue crucial nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a long-term 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 enrolled in school. New arrivals are documented by aid workers and state agents using digital identification.

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

Some residents have taken on new roles with enthusiasm: volunteers in the SOS Desert organisation cultivate food for sale and manage an blaze control team putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and expectant mothers while also spreading awareness about educating girls.

But the camp’s requirements are obvious.

“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 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 supplying school meals, basic food distributions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most vulnerable while working continuously to obtain new funding through the diversification of our funding sources.”

The meals are powered by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only items in a most of the warehouses. A few donors are also helping launch business programmes to help refugees cultivate and raise animals so they can earn an income and boost their standard of living.

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

“When you leave your country, you sacrifice everything – your work, your home, your family sometimes,” he says. “Here, you depend only on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you struggle.

“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.”