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Many days 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 routine keeps the 84-year-old camp elder healthy in mind and body, and enables him to monitor the wellbeing of other inhabitants.

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

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 conflict once again pushed him across the border.

The former math and science 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 not laid eyes on Mali,” he says. “They do not know their nation [and] that is difficult 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 houses around 120,000 refugees, according to UNHCR. In furthermore, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

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

Each month, thousands more refugees pour in across the border, fleeing a militant uprising that hijacked the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and adjacent settlements – cannot stop worrying. They have faced dwindling 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 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 trappings of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 shops, and volleyball and football programmes. Members of a parent-teacher association use megaphones to get more children registered in school. New arrivals are processed by aid workers and state agents using biometric systems.

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

Some residents have assumed new duties with enthusiasm: 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 support those wounded by jihadist attacks and mothers-to-be while also spreading awareness about teaching girls.

But the camp’s requirements are evident.

“We have the desire, we have the women, but not enough resources or supplies,” 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 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 legumes.

“We’re still supplying school meals, staple provisions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most needy while working tirelessly to acquire new funding through the diversification of our donor base.”

The meals are powered by recent contributions including several thousand tonnes of rice provided by the South Korean government – the only products in a most of the warehouses. A few donors are also helping start entrepreneurship programmes to help refugees farm and raise animals so they can earn an income and enhance their standard of living.

Though Malha supervises everything responsibly, helping the aid workers’ support the most disadvantaged households, his heart longs 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 enough, sometimes it is not. And when it is not, you endure hardship.

“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 self-respect.”