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

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

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

The former mathematics and physics teacher says he feels particularly sorry for the younger inhabitants of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the children 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 hopes to go back to one day.”

First established as a few thousand dwellings, Mbera now hosts around 120,000 refugees, according to UNHCR. In furthermore, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government representatives say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the governmental and business hubs.

Each month, thousands more refugees pour in across the border, escaping a extremist rebellion that hijacked the Tuareg rebellion and has since left swathes of the country uncontrollable. 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 feeling anxious. They have faced dwindling resources as foreign donors – most notably the now ceased USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to discontinue 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 trappings of a permanent settlement, including its own bank, eight schools, a market with more than 500 shops, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children signed up in school. New comers are processed by aid workers and state agents using digital identification.

Nearby, security patrols secure the camp from the danger of fighters just a few miles from the border.

Some residents have adopted new duties with zeal: volunteers in the SOS Desert organisation farm produce for sale and run an firefighting unit putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and pregnant women while also raising awareness about teaching girls.

But the camp’s demands are clear.

“We have the determination, we have the women, but not enough funding or supplies,” 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 gather by a big tray to eat the same meal every school day – rice that is mostly unseasoned, save for a few legumes.

“We’re still providing school meals, essential food aid, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most vulnerable while working relentlessly to acquire new funding through the expansion of our support network.”

The meals are supported by recent donations including several thousand tonnes of rice supplied by the South Korean government – the only products in a most of the warehouses. A few donors are also helping initiate business programmes to help refugees farm and keep animals so they can make money and improve their livelihood.

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

“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 dignity.”