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Many mornings a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The exercise keeps the 84-year-old camp coordinator healthy in mind and body, and enables him to assess the condition of other inhabitants.

His first stay in Mauritania occurred in 1991, when he left Mali as Tuareg separatists clashed with the army in his native Timbuktu region.

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

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

“Some of the kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their homeland [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.”

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

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

Each month, thousands more refugees arrive across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left extensive areas of the country ungovernable. 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 severely slashed funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to discontinue vital nutrition programmes for malnourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a permanent settlement, including its own financial institution, eight schools, a market with more than 500 outlets, and volleyball and football initiatives. Members of a parent-teacher association use loudspeakers to get more children enrolled in school. New arrivals are documented by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols protect the camp from the threat 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 operate an firefighting unit putting out bushfires; members of a women’s resource network look after those injured by jihadist attacks and expectant mothers while also raising awareness about teaching girls.

But the camp’s needs are evident.

“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 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 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, essential food aid, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re focusing on the most needy while working tirelessly to acquire new funding through the diversification of our support network.”

The meals are powered by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees cultivate and keep animals so they can make money and improve their quality of life.

Though Malha oversees everything responsibly, helping the aid workers’ assist the most needy 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 rely solely on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you endure hardship.

“We appreciate 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.”