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Many times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the enormous Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp coordinator mentally and physically fit, and allows him to monitor the welfare of other residents.

His first stay in Mauritania occurred in 1991, when he fled Mali as Tuareg separatists battled with the army in his home Timbuktu province.

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 unrest once again compelled him across the border.

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

“Some of the children who were born here in Mbera have never even seen Mali,” he says. “They do not know their country [and] that is heartbreaking because a refugee always has two hearts: 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 hosts 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 region. More than half are under 18.

Government officials say the area is the number three human community in Mauritania after Nouakchott and Nouadhibou, the governmental and business centers.

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 services the camp and neighbouring settlements – cannot stop feeling anxious. They have faced declining resources as foreign donors – most notably the now discontinued USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] assist almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to halt vital 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 bank, eight schools, a market with more than 500 stores, and volleyball and football programmes. Members of a parent-teacher association use amplifiers to get more children enrolled in school. New comers are processed by aid workers and state agents using fingerprint technology.

Nearby, security patrols protect the camp from the threat of fighters just a few miles from the border.

Some residents have assumed new roles with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women while also spreading awareness about educating girls.

But the camp’s requirements are clear.

“We have the will, 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 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 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 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 tirelessly to acquire new funding through the diversification of our support network.”

The meals are powered by recent donations including several thousand tonnes of rice supplied by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees cultivate and rear animals so they can generate funds and enhance their standard of living.

Though Malha oversees everything conscientiously, helping the aid workers’ support the most vulnerable households, his heart longs to return to Mali.

“When you leave your country, you lose everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you endure hardship.

“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.”