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Many times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The activity keeps the 84-year-old camp coordinator mentally and physically fit, and enables him to check on the wellbeing of other inhabitants.

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

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 pushed him across the border.

The former mathematics and physics teacher says he feels deeply sympathetic for the younger people of Mbera, which is situated 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 nation [and] that is difficult because a refugee always has dual loyalties: 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 houses around 120,000 refugees, according to the UN refugee agency. In also, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui province. More than half are under 18.

Government authorities say the area is the third-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left large parts of the country uncontrollable. Aid workers – notably 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 declining resources as foreign donors – most notably the now discontinued USAID – have severely slashed funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both food or cash every month to about 53,000 … and had to discontinue crucial nutrition programmes for hungry children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a long-term 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 megaphones to get more children signed up in school. New entrants are processed by aid workers and state agents using fingerprint technology.

Nearby, police patrols secure the camp from the threat of armed groups just a few miles from the border.

Some residents have adopted new roles with gusto: volunteers in the SOS Desert organisation cultivate food for sale and manage an anti-fire brigade putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and mothers-to-be while also spreading awareness about teaching girls.

But the camp’s needs are obvious.

“We have the determination, we have the women, but not enough funding or supplies,” a leading member of the network says. “Sometimes we repurpose 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 largely basic, save for a few legumes.

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

The meals are powered by recent donations including several thousand tonnes of rice provided by the South Korean government – the only goods in a most of the warehouses. A few donors are also helping start business programmes to help refugees grow crops and rear animals so they can make money and enhance their standard of living.

Though Malha supervises everything dutifully, helping the aid workers’ cater to the most disadvantaged households, his heart yearns to return to Mali.

“When you leave your country, you forfeit 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 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.”