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A number of days a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp elder vigorous, and allows him to assess the welfare of other occupants.

His initial stay in Mauritania occurred in 1991, when he left Mali as Tuareg insurgents fought with the army in his home Timbuktu region.

After four years as a refugee, he returned home and worked for a year as a community worker before becoming a teacher. Then in 2012, the Tuareg fighting once again compelled him across the border.

The former math and science teacher says he feels especially sad for the young residents of Mbera, which is positioned 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 longs to revisit one day.”

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

Government authorities say the area is the number three human settlement 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 uncontrollable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and adjacent settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now ceased USAID – have drastically cut funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to discontinue essential 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 financial institution, eight schools, a market with more than 500 shops, and volleyball and football initiatives. Members of a parent-teacher association use loudspeakers to get more children enrolled in school. New entrants are documented by aid workers and state agents using fingerprint technology.

Nearby, security patrols guard the camp from the threat of fighters 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 run an blaze control team putting out bushfires; members of a women’s resource network look after those maimed by jihadist attacks and pregnant women while also spreading awareness about schooling girls.

But the camp’s requirements are obvious.

“We have the determination, we have the women, but not enough financial support 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 cluster by a big tray to eat the same meal every school day – rice that is almost plain, save for a few legumes.

“We’re still offering school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most at-risk while working continuously to secure new funding through the broadening of our donor base.”

The meals are powered by recent gifts 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 start business programmes to help refugees grow crops and raise animals so they can make money and enhance their quality of life.

Though Malha oversees everything dutifully, helping the aid workers’ support the most needy households, his heart longs to return to Mali.

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

“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.”