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A number of times a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the sprawling Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp coordinator healthy in mind and body, and permits him to check on the condition of other residents.

His initial stay in Mauritania happened in 1991, when he escaped Mali as Tuareg insurgents battled with the army in his home Timbuktu region.

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

The former mathematics and physics teacher says he feels deeply sympathetic for the young residents of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have not once visited Mali,” he says. “They do not know their homeland [and] that is difficult 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.”

First established as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In furthermore, 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 representatives say the area is the number three human community in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees arrive across the border, running from a extremist rebellion that took over the Tuareg rebellion and has since left extensive areas of the country lawless. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby 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 food or cash every month to about 53,000 … and had to stop crucial 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 shops, and volleyball and football initiatives. Members of a parent-teacher association use loudspeakers to get more children registered in school. New entrants are processed by aid workers and state agents using digital identification.

Nearby, police patrols guard the camp from the threat of fighters just a few miles from the border.

Some residents have adopted new responsibilities with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and operate an firefighting unit putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and mothers-to-be 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 resources or equipment,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the needs of the camp.”

In the schools, the children are given 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 beans.

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

The meals are funded by recent gifts including several thousand tonnes of rice donated 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 keep animals so they can make money and boost their livelihood.

Though Malha manages everything conscientiously, helping the aid workers’ support 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 rely solely on humanitarian aid. Sometimes that aid is sufficient, 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 self-respect.”