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Several days a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the vast Mbera refugee camp in southeastern Mauritania that has been his home since 2012. The exercise keeps the 84-year-old camp elder healthy in mind and body, and allows him to assess the condition of other inhabitants.

His initial stay in Mauritania came in 1991, when he fled Mali as Tuareg insurgents battled 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 transitioning to a teacher. Then in 2012, the Tuareg unrest once again forced him across the border.

The former mathematics and physics teacher says he feels especially sad for the younger residents of Mbera, which is positioned 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 nation [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 dreams of returning to one day.”

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

Government authorities say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees come across the border, escaping a jihadist insurgency that co-opted the Tuareg rebellion and has since left extensive areas of the country uncontrollable. Aid workers – especially at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and neighbouring settlements – cannot stop worrying. 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] support almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to halt crucial nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a established settlement, including its own bank, 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 enrolled in school. New entrants are documented by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols secure the camp from the risk of fighters just a few miles from the border.

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

But the camp’s needs are clear.

“We have the determination, we have the women, but not enough funding 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 provided 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 largely basic, save for a few pulses.

“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 focusing on the most at-risk while working tirelessly to secure new funding through the expansion of our donor base.”

The meals are powered by recent contributions including several thousand tonnes of rice donated by the South Korean government – the only products in a bulk of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees cultivate and rear animals so they can generate funds and boost their livelihood.

Though Malha manages everything responsibly, helping the aid workers’ support 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 adequate, sometimes it is not. And when it is not, you struggle.

“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 self-respect.”