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Several mornings a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his residence since 2012. The activity keeps the 84-year-old camp elder vigorous, and enables him to assess the condition of other inhabitants.

His first stay in Mauritania came in 1991, when he fled Mali as Tuareg insurgents fought with the army in his home Timbuktu province.

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

The former mathematics and physics teacher says he feels particularly sorry for the young people of Mbera, which is situated 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 homeland [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 hopes to go back to one day.”

Initially conceived as a few thousand huts, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In furthermore, it is calculated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui area. More than half are under 18.

Government representatives 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 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 supports the camp and adjacent settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now discontinued USAID – have severely slashed 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 stop essential nutrition programmes for malnourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a permanent settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children signed up in school. New comers are processed by aid workers and state agents using fingerprint technology.

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

Some residents have adopted new duties with gusto: volunteers in the SOS Desert organisation cultivate food for sale and run an blaze control team putting out bushfires; members of a women’s resource network look after those injured by jihadist attacks and mothers-to-be while also raising awareness about educating girls.

But the camp’s demands are obvious.

“We have the desire, we have the women, but not enough financial support or supplies,” a leading member of the network says. “Sometimes we repurpose what little we have, but it is not enough for the needs 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 largely basic, save for a few pulses.

“We’re still offering school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working continuously to acquire new funding through the broadening of our donor base.”

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

Though Malha supervises everything dutifully, helping the aid workers’ support 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 are entirely reliant on humanitarian aid. Sometimes that aid is adequate, sometimes it is not. And when it is not, you suffer.

“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 self-respect.”