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Several mornings 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 residence since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and enables him to monitor the condition of other residents.

His first stay in Mauritania happened in 1991, when he escaped Mali as Tuareg rebels clashed with the army in his native Timbuktu province.

After four years as a refugee, he went back and worked for a year as a community worker before transitioning to a teacher. Then in 2012, the Tuareg unrest once again compelled him across the border.

The former math and science teacher says he feels especially sad for the younger inhabitants of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their nation [and] that is heartbreaking 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 hosts around 120,000 refugees, according to the United Nations High Commissioner for Refugees. In furthermore, it is approximated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government officials say the area is the number three human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, running from a militant uprising that hijacked 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 nearby 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] assist almost 90,000 people with both food or cash every month to about 53,000 … and had to discontinue essential 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 established settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football programmes. Members of a parent-teacher association use amplifiers to get more children signed up in school. New entrants are processed by aid workers and state agents using biometric systems.

Nearby, security patrols protect the camp from the danger of militants just a few miles from the border.

Some residents have taken on new responsibilities with zeal: volunteers in the SOS Desert organisation grow crops for sale and manage an anti-fire brigade putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women while also raising awareness about schooling girls.

But the camp’s demands are clear.

“We have the will, we have the women, but not enough funding or supplies,” 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 provided 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 almost plain, save for a few legumes.

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

The meals are supported by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only goods in a majority of the warehouses. A few donors are also helping launch business programmes to help refugees grow crops and raise animals so they can generate funds and boost their quality of life.

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 are entirely reliant on humanitarian aid. Sometimes that aid is sufficient, 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 dignity.”